1) Be prepared before you visit the first facility. Use friends, family, search engines, state information sites, key regulatory staff, blogs, treating physicians and other healthcare professionals as well as clergy, current or former employees, residents or their families as resources during your research in order to learn everything you can about the facilities you plan to visit. And DO make it more than one facility and more than one visit, if you have the luxury of competition in your area.
2) Work with your loved-one, her physician(s) and other healthcare providers and family members and friends to honestly and objectively determine the level of care and service needed now and for the foreseeable future. No one can predict the future, particularly when it comes to our health needs. But with a little work, you can reduce the chances of another move. Moves are tough on everyone and should be minimized even if they cannot be avoided altogether. In light of this objective, operators who have multiple levels of care on one campus may be a high priority on your list of desirables.
3) Explore and get agreement among all stakeholders regarding the absolutes and the desirables in your search. The absolutes are quality care and service, which can best be determined by following the processes I have outlined and included in the 10 Tips. Desirables, which can fluctuate in importance as you go through the selection process, may be proximity to family, to other caregivers or friends, hospitals, doctor offices, shopping facilities, parks, layout and appearance of the facility, as well as on-site services such as beauty salon/barber, social gatherings on-site, church services on-site, etc. You are, in fact, shopping for a home -- once you get past the non-negotiable absolutes of finding the best care and services possible. All homes have competing amenities that vary in value based on the eye of the purchaser(s).
4) The information you need and won’t take “no” for an answer on:
o Administrator credentials, work history, work practices (record keeping, policy tracking and enforcement, staff hiring, training and retention) and character. Get this information through the administrator herself and through staff and residents.
o The same information for key department heads—Director of Nursing, Dietary, Activities, Maintenance, etc.
o Latest State Surveys—complaint and annual. Ask for both!
o Caregiver staff stability. Get the numbers for turnover for last year, broken down by month.
o Copies of the resident agreement you would sign, facility policies and procedures, resident council meeting minutes/notes, Governing Board membership and records of meetings and actions, Quality Committee membership and their policies and procedures; an example of their charting practices with confidential data redacted.
o Get a list and explanation/demonstration of all systems and protocols they utilize to provide, review and improve care—drug administration, call-light monitoring, complaint tracking and resolution, prevention and monitoring of skin breakdown, hydration,prevention of weight loss, reduction of fall risks maintenance, etc.
o Ask about their practices of enlisting community support and services for their residents. Is it informal and uneven? Or is it structured, active and a valuable part of their service to the residents and family?
5. Documents to obtain or gain access to view: