Choosing a skilled nursing care center usually comes at a time when none of us is ready for it. An accident, a healthcare issue or other development has forced this decision on you. How should you go about choosing a care center for you or your loved one? The decision is often made as you or your loved one is being discharged from a hospital. Discharge planners can help guide you. Your family or attending physician will often be able to assist as well.

There are important factors to consider:

Referrals – Consult your doctor, your family and friends. Ask about their experiences with care centers.

Care Partners – This is an important consideration. Are they friendly? Do they seem to care about the Elders? Ask about the nursing care partner to Elder ratio.

Location – How close is the nearest center to you so you can visit as much as possible?

Tour – Make sure you visit the center or facilities you are considering in person. Ask for a tour and make notes about staffing, cleanliness, Elder care and payment/insurance issues. Ask to see what room your loved one will be given. Ask about roommates. Look at the dining facilities; ask about diet and nutrition planning. Stop and talk with care partners. Do they seem to care that you are taking a tour? Ask for references.

The Care Center

Below is an abbreviated checklist developed from the California Association of Health Facilities Web site detailing what you should look for in choosing a skilled nursing care center. For the complete list visit www.cahf.org. Print this out and take it with you as you visit various facilities. At Mission Care Group, we encourage you to ask about each one of these.

• Does the facility meet your standards of cleanliness?

• Is there a written description of resident rights and responsibilities? Ask for a copy.
• How does the staff protect resident privacy and dignity?
• Is the use of restraints kept to a minimum?

• Do individuals and families take part in developing their own care plan?
• Does the facility provide hospice services for terminally ill Elders and their families?
• Is there an Alzheimer’s disease program at the facility?

• Do care partners show interest in, affection and respect for the individuals?
• Are partners courteous? To each other?
• Is there a quick response to Elder calls of assistance?
• Is the administrator available to answer questions or discuss problems?

• Does the facility and administrator have a current license issued by the state?
• Is the latest state survey available for review?

• Does the basic daily charge cover all the services needed by the individual?
• Is there an available list of specific services not covered by the daily charge?

• Is a physician available in an emergency?
• Are personal physicians allowed to treat individuals?
• Does the facility report to the individual’s physician?
• Are care plans and medical records kept?
• Are a variety of medical services (dentists, podiatrists, optometrists) available?

• Does the facility have an arrangement with a nearby hospital?
• Is emergency transportation available?

• Are routine and emergency drugs available?
• Does a pharmacist review individual drug treatment plans?

• Is a physical therapy program available under the supervision of a qualified physical therapist?
• Are speech therapy and occupational therapy available?

• Are individual preferences observed? Is participation encouraged?
• Are the individuals involved in their surrounding community?
• Does the facility have volunteers working with the Elders?
• Are offsite trips planned?

• Is a social worker available to assist individuals and families?

• Do the bedrooms open onto the hallway? Windows?
• Does each bed have a privacy curtain?
• Is each bed equipped with a nurse call light?
• Is fresh drinking water available next to each bed?
• Is each individual provided a separate clothes closet or set of drawers?
• Are the bedrooms wheelchair-accessible?
• Are Elders encouraged to decorate rooms with personal items?

• Is the dining area clean, attractive and inviting?
• Are tables convenient for wheelchairs?
• Is food tasty and appealing to the eye?
• Do the meals match the posted menu?
• Is help given to the Elders who need it?
• Can Elders select their own meals?

• Are rooms available for Elder activities?
• Does the facility provide activity equipment, such as games or craft material?
• Is the equipment being used by Elders?

• Are toilets convenient to bedrooms? Are they wheelchair accessible?
• Are nurse call lights located near each toilet?
• Are handgrips installed near each toilet?
• Are bathtubs and showers equipped with non-slip surfaces and hand grips?

• Are the grounds accessible to handicapped individuals?
• Does the facility provide outdoor furniture for Elders and visitors?
• Are walkways clear and free of hazardous objects?

• Does the facility make arrangements for Elders to worship as they please?

• Does a dietitian plan menus for Elders requiring special diets?
• Are personal likes and dislikes considered?
• Does the menu vary from meal to meal?
• Is there adequate time to eat each meal?
• Does the facility provide snacks?
• Is food delivered to individuals unable to eat in the dining room?
• Is help given to the Elders who need it?

• Is assistance available for bathing and grooming?
• Are barbers or beauticians available?
• Does the facility provide basic laundry service?

If you are selecting a care facility for a loved one, are you:

• Involving the individual in the decisions?
• Ready to ease the individual’s transition to the facility by being with her/him during admission as well as staying several hours getting her/him settled?
• Prepared to visit the Elder often and encourage others to do the same?