What you should consider when looking for a Nursing Home/Assisted Living Center

Whether you are looking for yourself or for a family member, finding the best nursing home can be a frustrating process. It’s a new emotional and financial challenge, but the more equipped you are the better decision you’ll make.

What is a Assisted Living Center?
A nursing home is place for a person who can’t be cared for at home but doesn’t need a hospital. Nursing homes typically have a nursing staff on site 24 hours a day. Some are set up like hospitals with physical, speech and occupational therapy. Some have special units for dementia and Alzheimer patients.

Nursing homes are not only for the elderly; they are for anyone who needs 24-hour care.

Until recently, nursing homes were rigid and institutionalized. There were rules and a schedule for everything (waking, sleeping, eating, bathing, etc.). Now the culture is changing to one of resident-centered care. They want their residents to feel like they’re at home.

A good amount of nursing homes are households—groups of residents living under the same roof with the same staff sharing meals and activities. Some homes are on campuses with multiple households. Resident cats and dogs can often be found in the homes. And some homes let residents bring in their own pets.

Initial Searching
Before you do a lot of leg work, ask around.

  • Ask your doctor, family, friends, neighbors and clergy what experiences they have with nursing homes.
  • Ask a hospital’s discharge planner or social worker for recommendations especially if you’re in the hospital or were recently.
  • Contact a social service agency and talk to case manager about nursing home choices.
  • Contact your local Agency on Aging for recommendations.

Selecting the Right Nursing Home
After you’ve asked around (see above) and have some homes that sound promising, go for a visit. And think about these questions while you’re there. These questions will most likely lead to other questions.

Quality of Life
Is the staff respectful and friendly?
Is the nursing home clean?
Do they offer social, recreational, religious and cultural activities that interest you?
Can you choose your waking, bed time, and bathing time?
Can you get food and drinks when you want? Is the food good? Ask to try it.
Can you have friends and/or family visit anytime?
Can you have a pet?
Is transportation provided?
How much privacy is there?
Can you decorate your room how you like?
Is the temperature comfortable?
Is there good natural lighting?
Do you have a phone and television in the room?

For a number of other questions you should ask, visit AARP to see their checklist.

Quality of Care
To be a certified Medicare/Medicaid provider, a assisted living center must meet 150 requirements ranging from safe storage of food to protecting residents from physical and mental abuse. The State Survey Agency performs an inspection to rate the nursing home on these requirements. Ask to see a copy of this inspection report. You can also compare nursing homes on www.medicare.gov.

Will you get a copy of your care plan? Your care plan is based on your health information and must be assessed in the first 14 days and at least every 90 days thereafter.
Who are your doctors? Can you see your personal doctor?
What improvement goals is the nursing home working on?

Nursing Home Staffing
Federal law states there must be enough staff to care for the residents. What is enough? There must be at least one RN for at least 8 straight hours, 7 days a week. And there must be either an RN or LPN (Licensed Practical Nurse) on premises 24 hours a day.

Does the staff wear identification?
Does the staff know the residents by name?
Do they knock on residents’ doors before entering?
Is there a licensed doctor on the premises daily?

Costs will fluctuate based on the location, the type and amount of care, and who the provider is. Some nursing homes will charge extra for additional services while others will have “all inclusive fees.”

Some average costs for long-term care in the United States (in 2010) were:

  • $205 per day or $6,235 per month for a semi-private room in a nursing home
  • $229 per day or $6,965 per month for a private room in a nursing home
  • $3,293 per month for care in an assisted living facility (for a one-bedroom unit)
  • $21 per hour for a home health aide
  • $19 per hour for homemaker services
  • $67 per day for services in an adult day health care center
    • (These statistics are from http://longtermcare.gov/costs-how-to-pay/costs-of-care/)