Checklist for Selecting a Care Facility

/Home/Care Alternatives for Alzheimer's Patients/How to Choose Alzheimer's Care Facilities

This comprehensive checklist is from the California Handbook for Conservators:

GENERAL QUESTIONS

- Ask the Facility Administrator:
* Is the facility licensed by the appropriate state department?
The license should be posted in an obvious place. (California
Department of Social Services licenses board-and-care homes;
California Department of Health Services licenses intermediate-
care and skilled-nursing facilities).
* If it is a skilled-nursing facility, is the administrator licensed by the
state Board of Nursing Home Administrators? The license should
be posted in an obvious place.
* If the facility is advertised as a life-care or continuing-care facility,
does it have a valid certificate of authority from the Continuing
Care Program of the California Department of Social Services?
* Have there been any citations by the licensing authority?
* If so, have the problems been corrected?
* Is the facility certified to receive Medicare and Medi-Cal pay-
ments? Ask for a copy of the facility’s last certification report.
* Does the facility offer rehabilitation therapies such as occupational,
physical, and speech therapy?
* Are residents allowed to wear their own clothes?
* Are residents allowed to decorate their rooms?
* Are residents allowed to keep some of their own possessions,
including furniture?
* Is there a place for private visits with family and friends?
* Are the visiting hours convenient for residents and visitors?
* Is a list of residents’ rights posted in an obvious place?
* Are the rooms well-ventilated? At what temperature are rooms
kept?
* Can residents have a say in choosing roommates?
* Are social services available to residents and their families?
* Does the facility have recreational, cultural, intellectual, or reli-
gious activities?
* Are there group and individual activities? Ask to see a schedule of
events.
* Are activities offered for residents who are confined to their rooms?
* Is there an activities coordinator on staff?
* Are residents encouraged—but not forced—to take part in activities?
* Do staff members assist residents in getting from their rooms to
activities?
* Are residents encouraged to participate in activities outside the
facility?
* Do residents have the opportunity to attend religious services and
talk with clergy in and out of the facility?
* Are barber and beautician services available?
* Does the facility provide transportation for residents?
Does each resident have:
* A reading light?
* A comfortable chair?
* A closet?
* A chest of drawers for personal belongings?

- Ask Yourself:
* If the facility is a locked or secured-perimeter facility, do you have
the specific court authorization to place the conservatee in this
type of facility?
* Is the facility near the conservatee’s family and friends?
* Is the facility conveniently located on a bus route?
* Is the atmosphere warm, pleasant, and cheerful?
* Is there a sense of fellowship among the residents?
* Is the facility administrator courteous and helpful?
* Are staff members cheerful, courteous, and enthusiastic?
* Do staff members show residents genuine interest and affection?
* Do staff members seem attentive to residents’ needs? (If they are
watching TV, for example, they may not be attentive to residents.)
* Do the residents look well cared for and content?
* Do staff members appear to treat residents with dignity and
respect? (For example, do staff members knock before they enter
residents’ rooms?)
* Do residents, visitors, and volunteers speak favorably about the
facility?
* Is the facility clean and orderly?
* Does the temperature seem comfortable and the rooms well ven-
tilated?
* Is the facility reasonably free of unpleasant odors?
* Do bathing and toilet facilities offer adequate privacy?
* Is there a curtain or screen available to give each bed privacy?
* Is there a public telephone for residents’ use?
* Is fresh drinking water within reach?
* Is suitable space available for recreational activities?
* Are tools and supplies provided for recreational activities?
* Is there a lounge where residents can talk, read, play games,
watch television, or just relax away from their rooms?
* Does the facility have a yard or outdoor area where residents can
get fresh air and sunshine?
* Are there wheelchair ramps?
* Are toilet and bathing facilities easy for physically impaired resi-
dents to use?


SAFETY QUESTIONS

- Ask the Facility Administrator:
* Is the furniture attractive, comfortable, and easy for physically
impaired people to get into and out of?
* Is there an automatic sprinkler system?
* Are there portable fire extinguishers?
* Is there automatic emergency lighting?
* Are the smoke detectors, automatic sprinkler system, and auto-
matic emergency lighting in good working order?
* Are there fire drills for staff and residents?
* Is there a smoking policy for staff, residents, and visitors? What is it?
Are there nurse call buttons and emergency call buttons:
* At each resident’s bed?
* At each toilet?
* At each bathing facility?

- Ask Yourself:
* Are smoking policy rules observed?
* Is the facility free of obvious risks, such as obstacles, hazards, and
unsteady chairs?
* Are there grab bars in toilet and bathing facilities and on both
sides of hallways? Ask to see the bathrooms.
* Do bathtubs and showers have nonslip surfaces?
* Do all rooms open onto a hallway?
* Are exits clearly marked and exit signs illuminated?
* Are exit doors unobstructed and can they be unlocked from
inside?
* Are doors to stairways kept closed?
* Is the facility well lighted?
* Are hallways wide enough to allow wheelchairs to pass each other
easily?
* Is an emergency evacuation plan posted in a prominent place?


HEALTH SERVICE QUESTIONS

- Ask the Facility Administrator:
* In case of medical emergencies, is a doctor available at all times,
either on staff or on call? Ask for the names of doctors on staff or
on call.
* Does the facility allow residents to be treated by doctors of their
own choosing?
* Are residents involved in planning their own care?
* Is confidentiality of medical records assured?
* Has the facility made arrangements with a nearby hospital for
quick transfer in an emergency?
* Is emergency transportation available?
* Does the facility have an arrangement with a dentist to provide res-
idents with dental care on a routine basis or on an as-needed basis?
Ask for the names of dentists who provide care for residents.
* Are pharmaceutical services supervised by a pharmacist? Ask for
the pharmacist’s name.
* Does a pharmacist maintain and monitor a record of each resi-
dent’s drug therapy?
* Are residents allowed to choose their own pharmacy?
* Has a separate room been set aside for storing and preparing
drugs?
* Is there at least one registered nurse (RN) or licensed vocational
nurse (LVN) on duty day and night?
* Is an RN on duty during the day, seven days a week?
* Does an RN serve as director of nursing services?
* If the conservatee requires special services such as physical ther-
apy or a special diet, can the facility provide them?

- Ask Yourself:
* Is the conservatee’s doctor willing to visit the facility?


MEAL QUESTIONS

- Ask the Facility Administrator:
* Are at least three meals served each day?
* Are meals served at normal hours, with plenty of time for leisurely
eating? Ask to see the meal schedule.
* Are more than 14 hours scheduled between the evening meal
and the next day’s breakfast?
* May I visit the dining room during mealtime?
* Are nutritious between-meal and bedtime snacks available? What is served?
* Are special meals prepared for patients on therapeutic diets?
* Can visitors join residents at mealtime?
* Is there a charge for visitors’ meals?

- Ask Yourself:
* Ask to sample a meal. Does the meal that is served match the
posted menu?
* Are residents given enough food?
* Do the meals look appetizing?
* Does the food taste good?
* Is food served at the proper temperature?
* Is the dining area attractive and comfortable?
* Do residents who need help eating receive it, either in the dining
room or in their own rooms?
* Is the kitchen clean and reasonably tidy?
* Is food that should be refrigerated left standing out on counters?
* Is waste properly disposed of?
* Do kitchen staff follow good standards of food handling?


FINANCIAL QUESTIONS

- Ask the Facility Administrator:
What is covered by the basic monthly fee, and what isn’t covered?
* Is there a list of fees for specific services that aren’t included in the
basic rate?
* Is there a refund for unused days that were prepaid?
* Is there a minimum period (sometimes called a private pay period)
before the facility will accept Medi-Cal?
- Ask Yourself:
Does the contract between the resident and the facility clearly
state:
* Costs?
* The admission dates?
* Services that will be provided?
* Discharge and transfer conditions?
How does the cost compare with that of other facilities?