Currently there are a lot of care facilities that are licensed to operate in the state of California and evaluating these senior care facilities i.e. Assisted Living, Board & Care Homes, Memory Care, Independent Living, and Community Care Retirement Communities is a very important factor in choosing the right senior living option for our loved one. Quality and practical considerations need to be in sync in choosing the right kind of community. It may be the “best fit” but too costly or too far away for resident or family members to visit, it will not be probably practical to choose.
Keep in mind the following in using the evaluation guidelines in choosing the right senior assisted living and care facilities near you.
- It is always better to start the process early before there is a crisis.
- Involve the prospective resident as much as possible in the process.
- Use the checklist to get an overall feel for the facility and its practices.
- Pay special attention to how residents are being treated by staff and the quality and responsiveness of the services. Don’t be sold only on the attractiveness of the facility.
- Narrow the options down to two or three facilities.
- Visit each facility several times if you can.
- In making visits, walk through the whole facility and visit at different times of the day.
- Drop by unannounced and visit at night and/or on the weekend.
- Make sure that you visit during a mealtime.
Obtain a copy of the admission agreement. Read it carefully. Understand the services, costs and conditions for transfer. Admission agreement is a legal contract. It states the scope of responsibilities of both the facility and resident. It can also vary from one facility to another. Before signing anything, read and study it carefully.
Quality of Care and Services:
- Do residents appear well cared for?
- Are residents up, clean, and dressed by 10 AM?
- Are the residents well groomed, e.g., (shaved, clean clothes, nails trimmed, and hair done)?
- Is there a written plan of care for each resident? How often is the care plan reviewed and changed? By whom?
- Does the facility offer programs and/or services which meet your particular care needs, e.g., dementia unit, etc.?
- What is the system for distribution of medicaton? Who does it? What is their level of training?
- Does the facility have access to doctors, hospitals, home health agencies and adult day health care services?
- Does facility provide transportation to medical services? Charges?
- Are there clear procedures for responding to medical emergencies?
- Quality of Food
- Does the food appear and smell appealing? Are fresh ingredients used?
- Do residents seem to be enjoying the food?
- Are residents receiving the assistance needed in eating?
- Are meals served at appropriate temperatures?
- Do menus offer choice? How often are menus changed? (Ask to see a copy of the week’s menu.)
- Can the facility meet special dietary needs? Ethnic preferences?
- Are nutritious snacks available?
- Is fresh drinking water available?
- Can residents prepare meals in apartments?
- Does the facility make provisions to serve residents in rooms? Costs?
- Are residents interacting with staff and/or each other?
- Are residents occupied in meaningful activities?
- Does the facility have a planned activities program? Are activity calendars posted? On weekends?
- Is there a designated staff who coordinates activities? Are activities individualized or only done in large groups?
- Are there planned trips outside the facility?
- Is transportation provided for shopping and personal errands? Charges?
- Are pets allowed? Does the facility have pets?
- Are religious services offered at the facility?
- Are residents and family members involved in assessment and care planning?
- Do residents have an opportunity to provide input into menu and activity planning?
- Are there procedures for responding to requests for information and complaints?
- Is the Ombudsman Program’s poster and telephone number posted?
- Quality of Staff
- How long have the current owner/s been operating the facility?
- How long has the key staff been working at the facility, i.e., administrator and assistant administrator, activities coordinator, cook, and nurse consultant?
- Has there been a recent turnover in key staff?
- How many direct care staff are there for each shift?
- What is the staff to resident ratio? What is the ratio on the night shift? Weekends?
- What is the turnover rate among direct care staff?
- Does direct care staff understand and speak English?
- What special training do staff receive in working with persons with dementia?
- Does staff take time to talk with residents?
- Do administration and staff interact with residents in a respectful way?
- How long does it take for staff to respond to a resident’s request for help or to a call bell?
- Does staff respect residents’ privacy by knocking on doors or announcing themselves before entering rooms?
- Does the staff wear name badges?
- Is the overall décor pleasant and homelike?
- Is the environment clean and odor free?
- Is the facility quiet or noisy?
- Is the temperature comfortable?
- Does the building seem safe and free from dangerous hazards? Cluttered?
- Are the residents’ rooms, hallways, and common areas well lighted?
- Are floors of non-skid material and are carpets firm to ease walking and to prevent falls?
- Is the dining room pleasant and inviting?
- Are common areas, bedrooms, and bathrooms accessible to wheelchairs and walkers?
- Are bathrooms conveniently located?
- How many residents share a bathroom?
- Do all bathrooms, showers and bathtubs have handgrips or rails?
- Are call bells accessible to residents? By bed? In bathrooms?
- Is there privacy in residents’ rooms, especially in shared rooms?
- Is there any place to have a private conversation?
- Are residents encouraged to bring in some of their own furnishings?
- Is there a bedside table, reading light, chest of drawers and at least one comfortable chair for each resident?
- Is there a locked drawer to store valuables? If not, does facility make provisions to store valuables?
- Is there adequate space for clothing and personal belongings in each room?
- Does the facility have extra storage space for residents’ belongings?
- Is there a fenced yard? Locked?
- Is there a disaster plan posted? How often does the facility hold drills?
- Practical Dimensions
- Is the facility close to family and friends who will be visiting most frequently?
- Is the facility near public transportation?
- Is there adequate parking for residents that drive, and residents’ family and friends?
- Is the facility in an area where it would be safe to visit at night?
- Is the facility convenient to the resident’s doctor? Home health agency?
- Is the facility close to a hospital?
- Are family and friends welcome at any time or are there strict visiting hours?
- How did the administrator and staff treat you when showing you around?
- Did they answer all your questions to your satisfaction?
- Did they show you around the entire facility? Were any areas or sections not shown to you? Why?
- Do you feel that the administrator and staff are people you can work with and communicate with honestly?
- How would you or your loved one fit in? Is this facility compatible with your lifestyle?
- Can you imagine yourself or your loved one living here?
- How did you feel when visiting the facility?
- Do the estimated monthly costs (including extra charges) compare favorably with other facilities?
- Are there any upfront fees, e.g., assessment, community fees?
- Pre–admission fees must be refunded in full (100%) if the resident does not enter the facility, and the facility did not perform an appraisal (assessment) or failed to provide a written disclosure of the pre–admission fee charges and refund conditions. Proportional refunds of pre–admission fees more than $500 are required during the first three months:
80% if the person does not enter the facility but a pre–admission appraisal was done
80% if a resident leaves the facility during the first month for any reason
60% if a resident leaves the facility during the second month for any reason
40% if a resident leaves the facility during the third month for any reason
- Note: The facility cannot charge a security or damage deposit or a cleaning fee.
- What services are included in the basic rate? (Basic services usually include care and supervision, personal care, and services as needed by the resident that is indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing, toileting and personal hygiene – ADL’s, housekeeping, laundry, medication management support, wellness programs that is of interest and appropriate to resident, and three (3) nutritionally balanced meals and snacks.)
- What is the cost for extra services? Levels of care? How is the need for extra services or higher levels of care determined?
- What are the costs for specialized services, e.g., dementia unit?
- Will the facility continue to charge a resident who is transferred to a nursing home or hospital and does not return to the facility?
- Are the costs and payment schedule clearly described in the admission agreement?
- Ask the facility for a copy of the most recent rate increase disclosure statement to find out the average monthly rate increases (actual amount and percentage) for each of the previous three years.
- Are the total monthly charges affordable over time?
- Will the facility give you a copy of the admission agreement to take home and study before making a final decision?
Take time in choosing the right facility for your loved one. Call us to avail of FREE placement request to help you.