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How to Choose a Long-term Care Facility

Making the decision to move yourself, a friend or family member into a long-term care facility is one of the toughest decisions there is. No one wants to face losing their home, their independence or their place in the community.

But it isn’t a hopeless situation. By reviewing and visiting the facilities you are considering, you can find a place that fits your needs, both medically and socially.

Some important factors to consider are:

  • Level of care providedIn Missouri, there are several different levels of care provided in long-term care facilities. These are:

    • Assisted Living
    • Residential Care
    • Intermediate Nursing Facility
    • Skilled Nursing Facilities
  • Medicare and Medicaid participationIf you want Medicare or Medicaid (MOHealthNet) to help pay for long-term care facility services, you must select a facility that is certified by these programs. Medicare’s short-term skilled nursing facility benefit is very limited, but may help when skilled nursing care or therapy are needed after hospitalization due to a stroke, surgery, injury or other medical conditions. Medicare may cover up to 100 days of skilled nursing care following a hospital stay of at least three days. For more information on Medicare benefits, click here.
    Medicaid or MOHealthNet helps pay for skilled nursing home care for those requiring a longer stay that is not a follow-up to a recent hospitalization. MOHealthNet services are targeted to those with limited incomes and assets, who otherwise would not be able to pay for their care. For more information on Medicaid benefits, click here.

  • LocationIt is important to select a long-term care facility that is close and convenient to those who will be visiting the resident most often. Residents with frequent visitors often recover faster, are happier and tend to receive a higher quality of care. When family members and friends are close enough to visit frequently, they can help monitor the resident’s condition, participate in care planning and respond quickly to emergencies.

  • QualityThere are a number of tools available to help you determine the quality of care available at a specific nursing home. These include:

    • Show Me Long Term Care  The Department of Health and Senior Services is the agency in Missouri that is responsible for licensing and certifying all types of facilities in Missouri. This is usually done through an onsite visit by state surveyors every nine to 15 months. Complaint investigations may be done at any time, as needed. Problems that are found are called “deficiencies” and may be found by clicking here.

    • Nursing Home Compare  The Centers for Medicare and Medicaid Services (CMS), the federal agency responsible for ensuring quality of care under the Medicare and Medicaid programs, maintains considerable information on nursing homes that accept Medicare and Medicaid funding to care for residents. This website uses a five-star rating system to give you a quick means of comparing different facilities. You can search by city or zip code. To review this site, please click here.

Inspection findings and rating systems may not tell you everything you need to know about the quality of care in a facility. Use the information from Show Me Long Term Care and Nursing Home Compare, along with your own observations and opinions of those you trust, to determine the quality of the nursing homes under consideration.

  • Special NeedsIt is important that you find a long term care facility that can meet any special care needs your loved one may have. For example, does your parent need physical or occupational therapy? Do they need extra supervision and assistance due to behaviors associated with dementia? Are they on a specialized diet? Is English their second language? Do they like to stay up late and sleep in? Ask detailed questions to make sure facilities under consideration are willing and able to provide the necessary care.

  • Seek ReferencesIf possible, seek information about facilities under consideration from people you trust. Relatives, friends, clergy, neighbors, Long Term Care Ombudsman Programs, Alzheimer’s support groups, hospital discharge planners, doctors and others may have recent experiences with long term care facilities in your area. You can also seek opinions from residents and visitors while making visits to any long term care facility you are considering.

  • Personal VisitsNothing substitutes for a personal visit to the facility. Once you have identified a long-term care facility that seems to meet your needs, visit the facility. Ask to see the entire facility, not just the nicely decorated lobby or a designated unit.

    • Try to get a feel for the quality of care and how the staff interacts with the residents. Take note of resident appearance: are residents dressed appropriately? Is their hair combed? Are their eyeglasses clean? How many staff are there? Are they dressed well? Do they have a professional demeanor? Are they greeting residents? Are they responding to calls for help?

    • Look at the environment. Are residents’ rooms clean, how does the food look and smell? Are there activities going on? Does the facility smell and appear clean? Are the hallways cluttered?

    • How do you feel when you visit the facility? How does it compare to others? How did the administrator and staff treat you? Remember that you’ll be depending on these people to take care of your loved one. If you don’t like visiting there, imagine what it would be like living there.

    • People sometimes over-estimate the importance of an attractive building. While a long term care facility should be safe, clean and comfortable, it does not do the resident any good to choose a “pretty” facility if the resident cannot afford it, if it cannot meet his or her needs or if it is too far away for family and friends to visit.

If you would like a printable checklist to take with you as you visit long term care facilities, click here.

Do you have a concern you would like to share about a nursing facility? Please call 816/701-8265.