Some simple steps to follow as you and your loved one evaluate care facilities.

The decision to move to a care facility is a difficult one, so keep your search as simple and organized as possible. Once you and your loved one have decided that he or she should no longer live at home, follow these steps to ensure a smooth transition to residential care.

1. Select the appropriate type of facility
2. Locate suitable facilities and make contact
3. Hold preliminary visits
4. Narrow your selections and conduct interviews
5. Scrutinize the contract
6. Ask for licensing reports
7. Contact the long-term care ombudsman

1) Select the Appropriate Type of Facility

• Different facilities offer different levels of care, so it’s important to determine the type of facility that best suits your loved one. The list below provides information about the most common types of residential care.
• Independent Living Facilities usually include amenities such as entertainment, meals, and socialization. Some offer light housekeeping or transportation services, and a few have staff to administer medication and coordinate health care.
• Adult Residential Care includes licensed boarding homes that provide room and board, help with medications, and personal care. Residents also receive limited supervision.
• Adult Family Homes may accommodate couples and are licensed to care for up to six residents. They provide room, board, laundry, assistance with activities of daily living, personal care, and social services.
• Assisted Living Facilities emphasize privacy, independence, and personal choice. Most of these facilities provide meals, personal care, medication assistance, limited supervision, organized activities, and/or limited nursing services.
• Continuing Care Retirement Communities accept seniors while they are still independent, and then provide an expanding range of services—including professional nursing care—as needed.
• Nursing Homes provide residents with rooms, meals, recreation, personal care, 24-hour nursing care, and protective supervision. Nursing homes vary, but services should be licensed and follow both state and federal regulations.

2) Locate Suitable Facilities and Make Contact

Once you’ve determined the best type of facility, find out what your options are. Gather information about care facilities in your loved one’s area, and make a list of places you want to visit.

• Get recommendations from friends and family members.
• Doctors, social workers, and clergy members may also make referrals.
• Ask your loved one if his or her friends who have experience with residential care can offer opinions.

After you compile your list, make an initial round of phone calls. You may be able to eliminate several facilities with just a short exploration.

Ask basic questions about vacancies, number of residents, costs and method of payment, and participation in Medicare and Medicaid. Also consider such services as transportation, meals, housekeeping, recreation, special Alzheimer’s units, or medication policies.

3) Hold Preliminary Visits

It’s best if you and your loved one preview several care facilities together. Take the tours, listen to the administrative presentations, and consider the following:

• Look for the facility’s license. Ask to see it if you don’t.
• Take a close look at the building and grounds.
• Talk with some residents.
• Talk to the administrator or the person in charge of daily operations.
• Talk to staff members.
• Talk with other residents’ family members.
• Ask to see a copy of the admission agreement or contract.

4) Narrow Your Selections and Conduct Interviews

Return to those facilities that seem capable of fulfilling your loved one’s needs and talk with the residents. How do they feel about the facility? Talk with staff. Are they respectful? Knowledgeable? Compare your impressions of different facilities.

• The checklists in this section will help you evaluate nursing homes or assisted living facilities. Make multiple copies and keep a record of each visit.
• If possible, make an unannounced visit to the facility. Try to arrange an overnight stay for your loved one before making a final decision.

5) Scrutinize the Contract

Obtain a copy of the contract so you and your loved one can review the document, get advice from outside sources, and compile a list of questions.

• Because the admissions contract is legally binding, it’s wise to discuss it with a lawyer.
• Your loved one can change terms of the contract. Each change must be initialed by both your loved one and a facility representative.
• Be sure that the contract is correct before your loved one signs it.

A comprehensive contract should:

• State your loved one’s rights and obligations, including the facility’s grievance procedures.
• Specify how much money your loved one must pay each day or month.
• Detail prices for items not included in the basic monthly or daily charge.
• State the facility’s policy on holding a bed if your loved one leaves temporarily for reasons such as hospitalization or vacation.
• State whether the facility is Medicaid and/or Medicare certified.

6) Ask For Licensing Reports

Most facilities display their licenses and certificates. Ask to see these and take the time to examine them.

• Review the latest state survey or inspection.
• If the facility had deficiencies, make sure they’ve been fixed.
• If you’re looking at an assisted living facility connected to a nursing home, ask to see the nursing home’s inspection report and examine the administrative structure.
• Be wary of facilities that cannot produce these documents.

7) Contact the Long-Term Care Ombudsman

The ombudsman program examines the conditions of long-term care facilities on a regular basis, so local ombudsmen are a valuable source for information. While they cannot make recommendations, ombudsmen can provide information on complaints against each facility and indicators of good care.

• Ombudsmen monitor complaints about quality of care, as well as problems that residents have regarding eligibility for state programs, financial status, legal difficulties, and transfer assistance.
• The ombudsman program can offer a breakdown of residents’ rights and federal and state regulations.

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