Checklist for Selecting a Care Community

Where to start: Obtain a list of facilities in your desired location; many are included in the Retirement Connection Guide. Call the facilities you are interested in first; don’t wear yourself out visiting facilities that do not have openings. Be prepared to briefly describe the care requirements of the person in need of placement, including such challenging behaviors as wandering, aggressiveness or specific health concerns.

• Make an appointment to visit the facility. If you are interested in it, make a second unannounced visit, preferably on a weekend or evening.
• Read the most recent state survey regarding the facility; this report provides results from the annual licensing inspection conducted by the state’s Department of Health.
• If the prospective resident will be paying personally, ask to see an itemized list of the daily charges and clarify the billing procedures for additional items. For example, many facilities include personal care items.
• It is important to know you have the right to purchase medications at the pharmacy of your choice, but you are then responsible for either delivering the medication yourself or ensuring that the pharmacy will deliver the medications in a timely manner.
• Ask about the facility’s billing procedures and get the name and telephone number of the staff person to speak with if you have questions.
• Ask how money for the resident’s personal needs is handled.
• Medicare will pay for a limited amount of time in a nursing home depending on the rehabilitative needs of the resident. If the resident continues to stay in a facility and requires Medicaid assistance, it is important to choose a facility that accepts both forms of payment (Medicare and Medicaid) and can ensure a Medicaid bed will be available; otherwise the resident will be required to move to another facility that accepts Medicaid.
• Find out the name of the management company that operates the facility. Ask what other facilities this company operates in the region. You may want to review the health department surveys for these facilities to see if the company consistently provides good care.
• Meet the administrator, and supporting management staff. Ask how long they have worked at the facility. Be alert to frequent administrative changes. These are the people who will ultimately be responsible for correcting any concerns or complaints that you or the resident may have.
• Ask how complaints are addressed and how problems are resolved. Find out which staff person has been designated as the person to handle grievances.
• Is the facility clean? Are odors pervasive throughout the facility or in isolated areas? Are the odors temporary?
• Look at the residents’ rooms and bathrooms (with resident permission). Are they clean, comfortable and home-like?
• Is the bathroom clean and organized? Are the toiletries and personal items stored appropriately? Are towels and washcloths available?
• Do residents have easy access to a private telephone in a quiet place? Is the telephone equipped with a hearing-enhancement device?
• Can you easily find posted instructions on how to contact the ombudsman, the county health department, the adult protection division of the county department of social services and the county Medicaid office?
• Are pleasant areas available for private dining and family visits?
• Are the residents clean, well groomed and positioned comfortably?
• Are the residents up and active during the day? Are they engaged in activities or interacting with people in common areas?
• Visit with the residents. Ask them how they like the food, if they feel well cared for and if they have enough to do. Tell them that you are thinking about bringing someone to live there. Ask them if they like living there and would they recommend it to others.
• Look in the dining area during a meal. Are residents who need help being assisted in eating? Are adaptive devices, such as special utensils and dishes, used when appropriate?
• Are people served their meals promptly?
• Do the menus posted reflect what the residents are eating?
• Observe the interaction between the residents and the staff. How do staff members address the residents? It is usually not appropriate to address adults as “honey” or “sweetie.” Some residents like to be called by their first name; others prefer the formality of Mr. or Mrs.
• Do staff members respect the resident’s privacy? Do they knock at the resident’s door and wait for a response before entering? Are privacy curtains pulled and/or doors closed when personal care is provided?
• Are call lights within residents’ reach and are they answered within a few minutes?
• Are staff members wearing identification badges?
• Ask about staff training. What training requirements does the residence have? How much training do they receive? Who does the training?
• Do staff members acknowledge your presence? If you are visiting without a tour guide, someone should tactfully inquire about your presence at the facility.
• Do staff members look calm, well organized and attentive to the residents?

When you are considering a care community for yourself or a loved one, you want to find one that is a bright, comfortable, inviting place to live. You want a home that provides a variety of stimulating activities and has a history of providing good care to residents. It should be a place where family members are invited to participate in activities and meals. Some nursing homes offer additional services, such as outpatient rehabilitation services; temporary, short-term recovery assistance; respite care; assisted living; specialized care units; and hospice services.  These criteria will help you choose a nursing home that will meet your needs.