5 Steps for Assessing Long-Term Care Facilities

As we age, there may come a time when we or our loved ones require long-term care. Long-term care facilities provide a range of services, from nursing care to rehabilitation, and can offer a safe and supportive environment for seniors who require assistance with daily activities. However, choosing a long-term care facility is a significant decision that requires careful consideration. The Centers for Medicare and Medicaid Services publication “Your Guide to Choosing A Nursing Home” can help you research different long-term care options. The following steps can guide you in your evaluation process.

Determine your needs and wants

Before selecting a long-term-care facility, you must know what care is needed. Long-term care facilities provide several levels of care, including assisted living, skilled nursing, and memory care. Some properties offer varying levels of care under one roof, which can be a good option for people who want to move to a senior-care residence when they’re just starting to require help and then stay in place (by simply moving to another wing or floor) as their needs progress.

Before you look at any specific homes, prepare a list of things that matter to you, such as:

  • location – ease of family visits or familiar surroundings
  • social programs, and activities
  • setting – for example, near shops or by a park
  • type of accommodation – for example, a semi-private or private room
  • special accommodation requests – such as allowing pets or special dietary needs
  • specific focus – culture, religion, language

Assess costs and your ability to pay

Choosing the correct type of long-term care can be an enormous financial decision for many families. In addition to ensuring a senior’s health care needs are met, it’s important to consider budget. According to A Place For Mom’s research team’s analysis of the latest available data:

  • The median cost nationwide of assisted living is $4,500 per month ($54,000 per year).
  • The median cost nationwide of a private room at a nursing home is $9,034 per month ($7,908 per month for a shared room).
  • The median cost nationwide of a home health aide is $27 per hour.
  • The median cost nationwide of adult day health care is $78 per day.

Private insurance may cover some or all of the cost. Veterans may be able to get help paying for long-term care from the Department of Veterans Affairs. Medicaid rules vary by state, but it generally pays for long-term-care services (primarily nursing-home care). However, assets must basically be depleted to become eligible for Medicaid. Medicaid does cover assisted living in more than half of the states if the cost is less expensive than a nursing home. The American Council on Aging website provides information on facilities that accept Medicaid, Medicare, and Veteran’s Health Benefits.

Start your search

Once you know the type of facility you want, it’s time to start your search and create a list of properties that best meet your needs. Ask doctors, as well as friends and family, for recommendations. Several resources also help you develop a list of senior-care properties.

Eldercare Locator is a service of the U.S. Administration on Aging. It provides links to Area Agencies on Aging, which can provide a list of facilities and information about long-term-care options in your area.

A Place for Mom is the nation’s largest senior-care adviser service with a directory of about 19,000 senior-care properties, including facilities specializing in dementia care. Its advisers provide free assistance in finding care options.

Evaluate the quality of facilities.

Facilities must comply with specific requirements to receive payment under Medicare or Medicaid programs. Medicare’s Nursing Home Compare tool lets you compare skilled nursing facilities based on the quality of care they provide, determine their special services, and see the results of health and safety inspections. U.S. News & World Report also assesses nursing homes near you, providing short-term and long-term care ratings.

Visit prospective facilities

To know whether a facility is right for your loved one, visit it. Make an appointment to tour during the week and speak with administrators. Plan to make an impromptu visit on a weekend to see how the facility operates when the administrator isn’t there.

What to look for

  • Physical setup and overall cleanliness. The facility should look like a residence, not a hospital. Residents should be allowed to bring their furniture or other belongings to make their rooms or apartments feel more like home.
  • Watch the residents. Make sure they are in common areas and are active. The residence should have a list of daily programs posted. Make sure those programs are occurring.
  • Watch employees. Are nurses engaged with residents? What is the ratio of caregivers to residents? It should be at least 1 to 15 for assisted living and 1 to 8 for memory care. If you or your loved one is going to a place for a specific reason, ensure the facility has available resources and staff.
  • Range of services. Rather than focusing on the content of services available, consider whether the nursing home’s services fit your unique needs. For example, those with beloved pets might consider whether the facility allows pet visits, or spiritual individuals might want to verify that the facility provides access to religious services.

Final Thoughts

At Northern Way, we understand that choosing a long-term care facility can be difficult, but asking the right questions can help you make an informed choice. Please don’t hesitate to reach out to us to start a conversation about how we can help.


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