Study, learn and understand how to begin the process

Choosing a long term care facility for you, a relative or a friend is a difficult and agonizing decision.  Often there is not enough notice to evaluate all the information available.  This information should enable you to quickly determine which facilities are conveniently located, within your price range, offer required services and supervision and are capable of accepting Medicaid and / or Medicare.

After choosing four or five facilities which meet your needs, telephone each to discuss financial, medical and placement arrangements.  If placement seems possible, set up an appointment with the admissions staff.  Take a friend or relative with you if at all possible.

During this initial meeting discuss specific items such as costs, extra charges for services that are not covered under the basic cost, and policies pertaining to doctors, medication/pharmacies caring for specific problems, bed holds, discharge, etc.  Make sure you understand the basic policies of the facility. Obtain a written copy of the bed hold policy. 

You should tour the facility with a knowledgeable staff member.  On tour observe the following:

1.                  Is the home comfortable and homelike?

2.                  Are there any offensive odors?

3.                  Is the temperature level comfortable?

4.                  Are the floors and walls clean?

5.                  Are the residents well groomed?

6.                  Are the residents “gathered” in one area?

7.                  Are there a number of “restrained” residents?

8.                  Is there any privacy available to the residents?

9.                  Are residents comfortable around staff?

10.               Is there respect between staff and residents?

11.               Does the staff smile?

12.               Does there appear to be adequate staffing?

13.               Are the call lights responded to in a timely manner?

14.               Is food nutritional and appetizing?

15.               What is included in daily activities?

16.               Is there a resident council and/or family council?

17.               What is the noise level in the home?

18.               Be sure residents appear to be engaged in “meaningful” activities.

19.               Do you see residents just sitting with their meal in front of them – incapable of feeding themselves?

20.               Are halls over-crowded with equipment, soiled linen bins, house keeping carts, etc?

You should also ask the following:

1.                  If private pay, what is the wait list for a Medicaid bed – can your loved one age in place or will it mean having to move to another nursing home?

2.                  Can residents go outside to a pleasant secure area?

3.                  If there is a “SPECIAL CARE UNIT”, ask to see the disclosure statement on what qualifies it being “SPECIAL CARE.”

4.                  What is their End-Of-Life Policy?

5.                  Ask if the home has a staff/resident ratio and if so, what is it?

Ask to see the latest survey results.  This should be posted in the facility, if not, ask to see it.

After you have toured the facility and met with the necessary people, plan on making two or more visits, unannounced, during regular visiting hours.  Make these visits at different times from your original, for instance, if your first visit was at 10 a.m., return for a visit during mealtime and another in the evening.  This will provide you with a broader view of the facility.