Choosing a Long-Term Care Facility
Selecting a long-term care facility is a very difficult process and should be done only after gathering as much information as possible and doing lots of comparative shopping.
Types of Long-Term Care Facilities
Skilled Nursing Facilities (SNFs) - Licensed SNFs, also known as nursing homes or convalescent hospitals, provide 24-hour skilled nursing care. Staff includes nurses, nursing assistants, social services and activities staff. Skilled nursing care can be paid for privately, by private insurance, Medicare or Medi-Cal. For Medi-Cal or Medicare reimbursement, a facility must be certified to accept Medi-Cal or Medicare. A resident must also meet certain requirements for the care to be covered by Medi-Cal or Medicare.
Range of cost: $3500 - $6000 per month.
Residential Care/Assisted Living - These licensed facilities provide 24 hour non-medical care and supervision for individuals needing assistance with activities of daily living (dressing, bathing, medications). These facilities range in size of a private home to over 100 beds. The larger assisted living facilities frequently have small apartments for residents, though residents still eat the meals in a group setting. Payment methods most frequently are private or Supplementary Security Income (SSI) for low-income residents.
Range of cost: $1000 - $5000 per month. Note: Assisted living facilities typically break out charges based on resident care needs. The Admissions Contract should be thoroughly reviewed before signing.
Choosing a Facility
Sometimes the urgency of a placement precludes planning and one has to take the first available bed. However, one can always have their name placed on a waiting list of another facility if it is believed that the consequent move is in the best interests of the resident.
Include in your investigation the following resources:
Family physician
Hospital discharge planner
Religious Organizations
Close Friends and neighbors
Licensing Reports (See below for more information)
The Residential Care Counseling Program of Senior Advocacy Services can also be an important resource for long-term preplacement counseling and information on available community resources to help in the transition process or to help a senior remain at home. The Residential Counseling Program has available - information on services provided by all residential care/assisted living facilities in Sonoma County and current vacancies. For a counseling appointment call 707-526-4108 or for more information on this program click here.
In choosing a home consider the following:
Location - can be an important factor to consider consideration for visitation by
family members and friends. Also, make sure the senior's physician will come to
the facility you are considering.
Costs - Does the facility you are considering meet with your financial
requirements? Is there eligibility for Medicare, Medi-Cal and private insurance
available? The cost of care should be explained thoroughly with a detailed
accounting of what services are covered in the daily rate and what services are
not. Read the contract very carefully. Clarify the reimbursement policy that would
be applied if one does not stay the full length of the pre-paid period.
Nursing/Staff Care - When visiting look for the quality of relationship between
the staff and residents. Are they pleasant and friendly? Do they treat residents
with respect and dignity?
Food Service - In the process of making a decision, try to visit the facility during
mealtime. It is not only an excellent way to learn about the food served, but also
to get an overall idea about the quality of the facility. Are residents who need
assistance with eating getting help? Can special dietary needs be met?
Activities and Special Services - Look beyond the posted calendar of events.
Meet with the Activities Staff person to discuss in depth the nature of available
activities in light of the needs of your family member. What are provisions for
transportation to medical/dental appointments, outings, and shopping?
Viewing Licensing Reports
Licensing reports skilled nursing, residential care and assisted living facilities are
available for review at our office.
Facilities are required by law to post in a public place their most recent survey.
Licensing reports are an important element in choosing a long term care facility.
Reports provide details of annual surveys performed by the licensing agency as
well as individual incident reports that may or may not have resulted in a citation
to the facility. This information is important to know in the planning stage of
choosing a long term care facility.
Licensing reports for skilled nursing, residential care and assisted living facilities
are available at the Senior Advocacy Services office and State Licensing Offices.
Skilled Nursing Facilities
California State Dept. of Health Services,
Licensing and Certification
50 Old Court House
Square, Suite 200
Santa Rosa, CA
800-554-0349
Residential Care Facilities
California Dept. of Social Services
Assisted Living
Community Care Licensing
101 Golf Course Drive
Rohnert Park, CA
707-588-5026
Web Sites
The following three web sites provide useful information on nursing homes.
The California Nursing Home Search is a free service of the California Health Care Foundation for seniors, caregivers, family members, providers and consumers. It provides comprehensive information about the quality of nursing care in California
Nursing Home Compare developed by the federal government, provides nursing facility information on every Medicare and Med-Cal certified bed.
Nursing Home Guide Sponsored by California Advocates for Nursing Home Reform, this site provides information on all California nursing facilities.