How to Choose the Right RCFE for Your Loved One

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An aging individual who can no longer manage independent living requires long-term care in a residential care facility. The scenario is similar for those who are born or have acquired a disability. Finding the right residential care is complex as varying degree of care is needed for different individuals. This is especially the situation for the aging population with mental health needs or with intellectual disabilities. 

The California Department of Social Services and Family Caregiver Alliance provides a guide for consumers in choosing a residential care facility for seniors.

1. Identify your Needs

Will this facility meet the required care when the frailness or illness progresses?

Identify the present and future needsof your loved one and communicate them clearly to the facility staff. All licensees are required to provide basic services, but not all licensees can provide specialized services such as dementia care or hospice care. Take into consideration the compatibility of your loved ones and the other residents, and the availability of recreation and socialization programs. 

Will the size and layout of the facility be comfortable for your loved one?

Facilities have different sizes and layouts depending on the number of residents they can provide care for. Consider whether the facility is suitable for the assistive devices of your loved ones when moving around. Does your loved one need a calm atmosphere or a more active environment? Do they prefer to have more privacy or more community engagement?

Do you prefer to have the facility closer to family or your home?

Is proximity important for your loved one’s doctor appointments, meeting with friends, outings, and religious institutions? The closer the facility is to where you live, the easier it will be to visit often. You also get to know the facility staff, and they get to know you.

2. Choose a Sample of Facilities

The Community Care Licensing Division has a search tool on its website to help you locate facilities in a particular area and gather additional information about the facility, such as facility license status, date licensed, visits to the facility, complaints, licensing reports, and the Regional Office responsible for the facility.  You can contact your CCLD Regional Office if you wish to have access to public files, which contain citations, civil penalties, and administrative actions, if any. 

3. Visit the Facilities

Are the residents treated well?

Talk with the current residents and their families. Observe how the residents are being treated in the facility and if they are happy, respected, and well cared for. Evaluate the facility from the point of view of your loved one.

Are there social activities?

Are there social activities that your loved one will be interested in participating in? Check the facility schedule if there are organized outings, religious services, and holidays. Does the facility accommodate cultural differences? Is there an outdoor area, and how is it accessed by a resident? 

Do they accommodate the diet of your loved one?

What special diets are accommodated in the facility? Know the dietary restrictions of your loved one and whether they need assistance in eating. Check whether their diet will be accommodated or become a problem with the facility. If they need assistance, is there staff available to make sure that they are well fed? 

What can be brought to the facility?

Can you and your loved one decorate the facility with furniture and special mementos? Can your loved one bring their pets with them? 

What are the available amenities in the facility?

Can the residents go out on their own at any time? Are there amenities like internet, cable TV, beauty shop, pediatric visit, and pharmacy? Is there a doctor who sees the residents in the facility? Is there a pharmacy for your loved one’s medication, and is it covered by insurance?

Ask questions and make a second visit

Visit several facilities in person before making a decision. Make meetings with the director, nursing director, or other key staff members of the facility. Make sure to visit for a second time without calling ahead. 

4. Find out about costs

Facilities will have varying costs for the services they provide. Is there an automatic yearly fee increase? Is the increase limited to a certain percentage? Ask if these costs can be paid by Medicaid, Medicare, or other long-term care insurance.

5. Read the contracts

Read the contract and ask for clarification on anything that you do not understand. Read the policies and procedures for admission, retention, discharge, room changes within the facility, refund policy, and trial periods. Ask about the grievance procedures and find the name or number of the ombudsman for the facility.

Check whether there is a clause requiring binding arbitration instead of going to court for serious disagreements. A federal ruling prohibits this clause in nursing homes that receive Medicare or medicaid funding. You have the option to sign it or not. 

Resources

The National Institute on Aging provides the following resources in choosing a long-term care facility:

• Call your local Area Agency on Aging or the Department of Human Services in your state or local government.

• Call 800-677-1116 for help finding care in your area or use the Eldercare Locator.

• To find and compare nursing homes and other health care facilities, you can use Medicare’s Care Compare tool. 

Learn more about the CDSS CCLD guide in choosing an RCFE in California.

If you missed part one of our article on knowing the different residential care facilities, read here.