Selecting a long-term care facility is a very difficult process and should be done only after gathering as much information as possible and doing lots of comparative shopping.

Types of Long-Term Care Facilities

Skilled Nursing Facilities (SNFs) - Licensed SNFs, also known as nursing homes or convalescent hospitals, provide 24-hour skilled nursing care. Staff includes nurses, nursing assistants, social services and activities staff. Skilled nursing care can be paid for privately, by private insurance, Medicare or Medi-Cal. For Medi-Cal or Medicare reimbursement, a facility must be certified to accept Medi-Cal or Medicare. A resident must also meet certain requirements for the care to be covered by Medi-Cal or Medicare.
Range of cost: $5000 - $9000 per month.

Residential Care/Assisted Living - These licensed facilities provide 24 hour non-medical care and supervision for individuals needing assistance with activities of daily living (dressing, bathing, medications). These facilities range in size of a private home to over 100 beds. The larger assisted living facilities frequently have small apartments for residents, though residents still eat the meals in a group setting. Payment methods most frequently are private or Supplementary Security Income (SSI) for low-income residents.
Range of cost: $1800 - $6000 per month. Note: Assisted living facilities typically break out charges based on resident care needs. The Admissions Contract should be thoroughly reviewed before signing.

Choosing a Facility

Sometimes the urgency of a placement precludes planning and one has to take the first available bed. However, one can always have their name placed on a waiting list of another facility if it is believed that the consequent move is in the best interests of the resident.

Include in your investigation the following resources:

• Family physician
• Hospital discharge planner
• Religious Organizations
• Close Friends and neighbors
• Licensing Reports (See below for more information)

In choosing a facility, consider the following:

• Location - can be an important factor to consider consideration for visitation by family members and friends. Also, make sure the senior's physician will come to the facility you are considering.
• Costs - Does the facility you are considering meet with your financial requirements? Is there eligibility for Medicare, Medi-Cal and private insurance available? The cost of care should be explained thoroughly with a detailed accounting of what services are covered in the daily rate and what services are not. Read the contract very carefully. Clarify the reimbursement policy that would be applied if one does not stay the full length of the pre-paid period.
• Nursing/Staff Care - When visiting look for the quality of relationship between the staff and residents. Are they pleasant and friendly? Do they treat residents with respect and dignity?
• Food Service - In the process of making a decision, try to visit the facility during mealtime. It is not only an excellent way to learn about the food served, but also to get an overall idea about the quality of the facility. Are residents who need assistance with eating getting help? Can special dietary needs be met?
• Activities and Special Services - Look beyond the posted calendar of events. Meet with the Activities Staff person to discuss in depth the nature of available activities in light of the needs of your family member. What are provisions for transportation to medical/dental appointments, outings, and shopping?

Viewing Licensing Reports

Licensing reports skilled nursing, residential care and assisted living facilities are available for review at our office.
Facilities are required by law to post in a public place their most recent survey.
Licensing reports are an important element in choosing a long term care facility. Reports provide details of annual surveys performed by the licensing agency as well as individual incident reports that may or may not have resulted in a citation to the facility. This information is important to know in the planning stage of choosing a long term care facility.
Licensing reports for skilled nursing, residential care and assisted living facilities are available at the Senior Advocacy Services office and State Licensing Offices.

Skilled Nursing Facilities
California State Dept. of Public Health,
Licensing and Certification
2170 Northpoint Parkway
Santa Rosa, CA 95407
707-576-6775

Residential Care Facilities
California Dept. of Social Services
Assisted Living
Community Care Licensing
101 Golf Course Drive
Rohnert Park, CA
707-588-5026