- Is the nursing home Medicare-Certified?
- Is the nursing home Medicaid-Certified?
- Does the nursing home have the level of care I need?
- Does the nursing home have a bed available?
- Does the nursing home offer specialized services, such as a special unit for care for a resident with dementia, ventilator care, or rehabilitation services?
- Is the nursing home located close enough for friends and family to visit?
- Are the residents clean, well groomed, and appropriately dressed for the season or time of day?
- Is the nursing home free from over whelming unpleasant odors?
- Does the nursing home appear clean and well kept?
- Is the temperature in the nursing home comfortable for residents?
- Does the nursing home have good lighting?
- Are the noise levels in the dining room and other common areas comfortable?
- Is smoking allowed? If so, is it restricted to certain areas of the nursing home?
- Are the furnishings sturdy, yet comfortable and attractive?
- Does the relationship between the staff and residents appear to be warm, polite, and respectful?
- Does the staff wear name tags?
- Does the staff knock on the door before entering a resident’s room? Do they refer to residents by name?
- Does the nursing home offer a training and continuing program for all staff?
- Does the nursing home check to make sure they don’t hire staff members who have been found guilty of abuse, neglect or mistreatment of residents; or have a finding of abuse, neglect or mistreatment of residents in the state nurse aid registry?
- Is there a licensed nursing staff 24 hours a day, including a Registered Nurse (RN) present at least 8 hours per day, 7 days a week?
- Will a team of Nurses and Certified Nursing Assistants (CNAs) work with me to meet my needs?
- Do CNAs help plan the care of residents?
- Is there a person on staff that will be assigned to meet my social service needs?
- If I have a medical need, will the staff contact my doctor for me?
- Has there been a turnover in administration staff, such as the administrator or director of nurses, in the past year?
- Can residents have personal belongings and furniture in their rooms?
- Does each resident have storage space (closet and drawers) in his or her room?
- Does each resident have a window in his or her bedroom?
- Do residents have access to a personal phone and television?
- Do residents have a choice of roommates?
- Are there policies and procedures to protect residents’ possessions, including lockable cabinets and closets?
- Are exits clearly marked?
- Are there quiet areas where residents can visit with family and friends?
- Does the Nursing home have smoke detectors and sprinklers?
- Are all common areas, resident rooms, and doorways designed for wheelchair use?
- Are handrails and grab bars appropriately placed in the hallways and bathrooms?
- Do residents have a choice of food items at each meal? (Ask if your favorite foods are served.)
- Can the nursing home provide for special dietary needs (like low-salt or no-sugar-added diets?)
- Are nutritious snacks available upon request?
- Does the staff help residents eat and drink at mealtimes if help is needed?
- Can residents, including those who are unable to leave their rooms, choose to take part in a variety of activities?
- Do residents have a role in planning or choosing activities that are available?
- Does the nursing home have outdoor areas for resident use? Is the staff available to help residents go outside?
- Does the nursing home have an active volunteer program?
- Does the nursing home have an emergency evacuation plan and hold regular fire drills (bed-bound residents included)?
- Do residents receive preventive care, like a yearly flu shot, to help keep them healthy? Does the facility assist in arranging hearing screenings or vision tests?
- Can residents still see their personal doctors? Does the facility help in arranging transportation for this purpose?
- Does the nursing home have an arrangement with a nearby hospital for emergencies?
- Are care plan meetings held with residents and family members at times that are convenient and flexible whenever possible?
- Has the nursing home corrected all deficiencies (failure to meet one or more state or Federal requirements) on its last state inspection report?
- What improvements were made to the quality of life for residents in the last year?
- What are the plans for future improvements?
- How has the nursing home responded to recommendations for improvement?
- Who does the Council report to?
- How does membership on the Council work?
- Who sets the agendas for meetings?
- How are decisions made (for example, by voting, consensus, or one person makes them)?
- 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 medication? 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?
- 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?
- Do volunteers and outside groups regularly visit the facility?
- 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?
- Are residents and family members involved in roommate selection?
- 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?
- Does the facility have a residents’ council? Does the facility have a family council or support group?
- 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?
- Do the administration and staff know the residents by name?
- 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?
- Are there outside sitting and walking areas for residents? Are any covered to protect from sun or rain?
- Is there a fenced yard? Locked?
- Are there enough fire and carbon monoxide detectors?
- Is there a designated smoking area? Inside? Outside?
- Is there a disaster plan posted? How often does the facility hold drills?
- 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?
- Does the facility have a good reputation in the community?
- Will they give you a list of references?
- Are residents and/or family members willing to talk with you about the facility?
- 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?
- Are Supplemental Security Income (SSI) residents accepted?
- Do the estimated monthly costs (including extra charges) compare favorably with other facilities?
- Are there any upfront fees, e.g., assessment, community fees?
- What services are included in the basic rate?
- 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?
- Start the process early before there is a crisis.
- Involve the prospective resident as much as possible in the process.
- 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.
- In making visits, walk through the whole facility and visit at different times of the day. Make sure you visit during a mealtime.
- Drop by unannounced and visit at night and/or on the weekend.
- Obtain a copy of the admission agreement. Read it carefully. Understand the services, costs and conditions for transfer.
- Before you make a final decision, check the latest survey report and any other citations issued by the state licensing agency. Facilities should make these reports available to you upon request. Or you can view the reports at the community care licensing office, California department of social services, or at some ombudsman offices
- Look at survey results from the state licensing agency that shows the facility’s history with regulatory compliance or noncompliance. (this is public data)
- Check court records to determine if the facility been sued for neglect
- Conduct on line research regarding the Medicare’s nursing home compare website that ranks nursing homes from best to worst.
- Take an on-site tour of facility. You senses of smell, sound and sight are great common sense predictors of quality.
- Meet and interview staff and administrator
- Ask about staffing levels, activities and resident opinion surveys, family member opinion surveys, read resident & family council minutes.
- Make sure the facility is able to clearly communicate in the senior’s first language.
- If it is important that the senior is seen by his or her own personal physician, confirm that he or she can see resident at facility?
- If not, meet facility medical director and research his/her background.
- Take the admission agreement home and read it carefully to see what services are included in the base price, as opposed to extra costs
Home Health Care
Home health care is probably the first choice for most people. With home health care the senior contracts with a licensed or unlicensed care giver to provide supportive services at home on an intermittent basis or 24 hours a day, depending on specific needs. The down side of home health care is the cost. It can be prohibitively expensive.
Unlicensed Assisted Living
The typical unlicensed assisted living facility is generally an apartment type setting where a central dinning facility is provided. Residents can privately contract out for higher level of care but the facility is not a health care provider.
Licensed Residential Care facilities for the Elderly (Assisted Living)
Residential Care Facilities for the Elderly (RCFE) are a housing arrangement chosen voluntarily by persons 60 years of age or over and persons under 60 with compatible needs. RCFEs provide varying levels and intensities of care and supervision, protective supervision, and personal care, based upon the resident’s needs. They includes secure Alzheimer units where residents receive 24 hour care with activities of daily living.
Know Your Assisted Living (RCFE) Rights
Assisted Living Checklist
Stay Updated on Your Assisted Living HomeSkilled Nursing Facility
Skilled nursing care facilities, commonly referred to as nursing homes, are licensed healthcare facilities that are inspected and regulated by a state’s Department of Health Services.
They offer long- and short-term care for individuals who need rehabilitation services or who suffer from serious or persistent health issues, such as Alzheimer’s disease, that are too complicated to be tended to at home or at an assisted living facility.
Federal and State laws and regulations set forth patient rights. Nursing homes are required to inform residents of these rights and protect and promote their rights.
Acute Care Facility
Most generally called a hospital.
Continuing Care Retirement Community (CCRC)
Continuing Care Retirement Communities (CCRCs) offer persons 60 years of age or older a long term continuing care contract that provides for independent living units, residential care/assisted living services, and skilled nursing care, usually in one location, and usually for a resident’s lifetime. Most CCRCs require a substantial entrance fee (e.g., from a low of $100,000 to over a million) to be paid by the applicant upon admission along with monthly fees.
Look at Survey Results
Look at survey results from the state licensing agency that shows the facility’s history with regulatory compliance or noncompliance. (This is public data)
Check Court Records
Check court records to determine if the facility been sued for neglect.
Check Online
Conduct on line research regarding the Medicare’s nursing home compare website that ranks nursing homes from best to worst.
Take a Tour
Take an on-site tour of facility. Your senses of smell, sound and sight are great common sense predictors of quality.
Meet the Staff
Meet and interview staff and administrator.
Ask Questions
Ask about staffing levels, activities and resident opinion surveys, family member opinion surveys, read resident & family council minutes.
Language Barriers?
Make sure the facility is able to clearly communicate in the elder’s first language.
Care Barriers?
If it is important that the senior is seen by his or her own personal physician, confirm that he or she can see resident at facility? If not, meet facility medical director and research his/her background.
Don’t Make a Quick Decision
Take the admission agreement home and read it carefully to see what services are included in the base price, as opposed to extra costs.
A Safe Living Environment
Assisted living facilities are specifically designed to accommodate aging seniors to facilitate mobility and avoid falls. They have shower railings, call buttons, wheel chair accessible areas, to name a few. Equally important, there is generally 24-hour security with staff on hand at all times. Depending on the level of need, staff can periodically check on the senior throughout the day and evening. Staff can also make sure the senior does not become isolated and withdrawn.
Help with Activities of Daily Living
“Assisted” living means just that – Assistance. Most places offer services to help with all activities of daily living (ADLs) such as bathing, dressing, and eating. They are staffed with individuals trained to help older adults with these ADLs so that they can continue to function as independently as possible.
Three Square Meals a Day
Assisted living facilities have a kitchen staff trained to create well balanced meals with an eye towards variety and proper nutrition. Seniors living alone at home don’t always have the desire to prepare meals that include the various food groups. In assisted living, residents are served three meals a day tailored to the changing health needs of older adults. Some luxury communities even offer gourmet dining!
Access to Physical Activity and Fitness
Modern assisted living facilities offer the latest in gym equipment and group exercise classes like water aerobics, yoga and Zumba classes. Find a facility with personal trainers that are trained to meet the basic fitness and range of motion needs of older adults, all under one roof.
Lots of Social Activities and Intellectual Stimulation
In assisted living, residents can easily socialize with peers, not only in common areas but also through planned, structured activities like field trips, dancing, and cultural events. Among the various activities that assisted living communities provide are plenty of chances for lifelong learning, from computer classes to book clubs to art classes. Many facilities even offer guest lectures from visiting scholars and professionals.
Housekeeping and Transportation: All Taken Care Of
In assisted living communities, housekeeping is usually included in the monthly cost, thus relieving the senior and his or her loved ones from the burden of laundry, dish washing, household cleaning and upkeep. Many facilities also offer transportation services to medical appointments, pharmacies, shopping malls, libraries and other places.
Nursing Home Check List
Use the Nursing Home Checklist when you visit a nursing home.
Take a copy of the Nursing Home Checklist with you when you visit to ask questions about resident life, nursing home living spaces, staff, residents’ rooms, hallways, stairs, lounges, bathrooms, menus and food, activities, safety and care.
Basic Information
Resident Appearance
Nursing Home Living Spaces
Staff
Residents’ Rooms
Hallway, Stairs, Lounges, and Bathrooms
Menus and Food
Activities
Safety and Care
Resident Council or Family Council Meeting
Download the Nursing Home Checklist
Prepared by California Advocates for Nursing Home Reform (CANHR)
At Elder Protection Center we’re here to help you and the ones you love to navigate the complexities and concerns that often come with aging.
Protect the People You Love is our number one priority. You are not alone. We’d love to hear from you. Elder Protection Center is standing by for you and your loved ones – Today.
Assisted Living Checklist
Quality of Care and Service
Quality of Food
Quality of Social Interaction
Quality of Participation
Quality of Staff
Quality of Environment
Practical Dimensions
Accessibility
Suitability
Affordability
Click here to see which senior living communities earned the Caring Stars distinction in your state this year.
Download the Assisted Living Checklist
Prepared by California Advocates for Nursing Home Reform (CANHR)
At Elder Protection Center we’re here to help you and the ones you love to navigate the complexities and concerns that often come with aging.
Protect the People You Love is our number one priority. You are not alone. We’d love to hear from you. Elder Protection Center is standing by for you and your loved ones – Today.
Nursing Home vs. Assisted Living
Understanding the difference between skilled nursing care and assisted living can be confusing. A skilled nursing facility may be needed if your family member requires: around-the-clock nursing care, medical treatments, IV medications and a level of care just short of a hospital. A nursing home provides, assistance with meals, personal hygiene, medications and more help than the family or present caregiver can provide.
Know Your Nursing Home Rights
Tips on Selecting a Nursing Home
Nursing Home Checklist
Assisted living communities are recommended when the senior does not require much medical care but they do need more assistance than can be provided in their home. Assisted living facilities allow residents to live independently in their own “apartment.” Assisted living provides meals, housekeeping and transportation services whether it be to the store, hairdresser/barber or a medical appointment. Assisted living communities have a scheduled calendar of events for residents and their families that may include arts and crafts, and field trips. They may offer assistance with dressing, personal hygiene and medications. Some have a resident doctor and/or registered nurse on staff. Many have secured Alzheimer’s/Dementia units that pay extra close attention to those residents who may stray if left unsupervised.
Assisted Living Checklist
Elder Protection Center strives to provide you with valuable information about a variety of issues facing our aging population. Our Tips and Resources will help you to seek out long term care or help with transitioning to new living arrangements. Learn about safety devices and technology to make your home safer, understand important legal documents and more, all in one great resource.
Tips When Selecting a Short or Long Term Living Arrangement
Carefully Select Caregiver
Ask caregiver to provide referrals. Don’t just rely on calling the referrals. Make sure they are legitimate. Offer to buy him or her a cup of coffee so you can meet and evaluate them. When you find a caregiver you like, conduct a background check. There are many reputable companies that can do that for a reasonable fee. Keep in mind, there is no current law requiring mandatory background checks for in-home caregivers in California. You should do it yourself.
Carefully Select Assisted Living Home
Stay Updated on Your Assisted Living Home
Carefully Select Nursing Home
Selecting a nursing home for yourself, a loved one, or a friend is an important and often difficult decision. Ideally, you will have the time to gather the many facts you’ll need to make that decision. Unfortunately, that decision is often made in a crisis atmosphere, when a person is about to leave the hospital or after a serious illness or operation.
Finding the right nursing home is all-important to you or your loved one’s well-being. The nursing home selected will be the person’s home for the duration of his or her stay, and sometimes for the remainder of a person’s life. A careful search for a nursing home will prevent future problems. The following tips are intended to give you some guidelines in selecting the most appropriate nursing home for you or your loved one.
Nursing Home Checklist
At Elder Protection Center we’re here to help you and the ones you love to navigate the complexities and concerns that often come with aging.
Protect the People You Love is our number one priority. You are not alone. We’d love to hear from you. Elder Protection Center is standing by for you and your loved ones – Today.
Types of Care Arrangements for the Elderly
Short & Long-Term Living Arrangements for the Elderly
Elder Protection Center strives to provide you with valuable information about a variety of issues facing our aging population. Our Tips and Resources will help you to seek out long term care or help with transitioning to new living arrangements. Learn about safety devices and technology to make your home safer, understand important legal documents and more, all in one great resource.
Tips When Selecting a Short or Long Term Living Arrangement
Nursing Home vs. Assisted Living
Tips on Selecting a Nursing Home
6 Great Reasons for Assisted Living
Assisted living communities provide 24-hour access to personal care, as well as nutrition and wellness services designed specifically for older adults. Seniors can enjoy social contact, security and support while still maintaining their independence. Assisted living is a great intermediate step for seniors who need more help than the family can provide at home, but who don’t need the round-the-clock medical care of a nursing facility. Read on for six great reasons to consider assisted living for your loved one.
At Elder Protection Center we’re here to help you and the ones you love to navigate the complexities and concerns that often come with aging.
Protect the People You Love is our number one priority. You are not alone. We’d love to hear from you. Elder Protection Center is standing by for you and your loved ones – Today.
