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Assisted Living, Questions to Ask Yourself – Richmond, VA

- Monday, October 07, 2013

Finding reliable data on assisted living isn’t easy. Federal and state statistics can be hard to come by.

So where do consumers begin if they’re considering sending a loved one to assisted living? We put that question to several experts. Here is what they had to say:

1. What Are Your Needs?

Assisted living isn’t for everyone, so it’s important to understand what level of care you need and how that may change with age. Experts say that is especially true when it comes to seniors with dementia.

A recent study found that 46% of assisted living residents suffered from at least three chronic conditions, yet only 54.5% of facilities surveyed in the study had a registered nurse or a licensed practical nurse on staff.

Assisted living facilities can have limited medical staffs, so if a medical staff is- or may become- necessary, ask the questions.

2. Have You Visited?

If you have decided on assisted living, it’s important to visit prospective facilities multiple times. It is recommended that you visit at different times of the day — meal times are a good place to start.

It’s not enough to just tour the building with the director. Instead, take time to talk to residents and staff for a sense of the facility’s culture and environment. Ask about available services and about what staffing is like throughout the day and at night. It doesn’t hurt to inquire about turnover either, as that can be a good indicator of how reliable services will be, as well as how well the staff understands residents’ needs.

For residents with dementia, it’s also important to understand how the facility manages their care and safety. For example, what kind of programming is available? Are the doors locked at night for residents who wander?

3. For-Profit or Non-Profit?

It’s also important to consider whether the facility is a for-profit, or not-for-profit institution, as that may influence how resources are allocated for care.

About 82% of residential care facilities are private, for-profit facilities, with about four in 10 belonging to a national chain. There are good and bad facilities in each category.

4. What Are the True Costs?

Assisted living can expensive, and because it is not covered by Medicare, for many seniors, the cost can be prohibitive.

The sticker price, however, often won’t account for the fees a facility charges for additional services. Some facilities will charge a resident extra for meal delivery, while others add on fees for services such as transportation to and from the facility, or laundry and housekeeping. Likewise, fees for bathing assistance, dressing assistance and medication management can add thousands of dollars a month to the base rate.

5. What’s in the Admissions Agreement?

Admissions agreements can be lengthy and complicated, so experts advise taking your time to read them carefully. Occasionally buried in the fine print is language requiring 30 days notice to stop billing for services, even if the person staying there has died.

Another red flag are so-called negotiated risk agreements. These clauses are often offered as a way for residents to make preferred choices about their care, even if they present some risks. For many in the industry, they are seen as a way to help seniors preserve a sense of independence.

Liability waivers, another common part of admissions agreements, can present the same problem.

If any part of the admissions agreement is unclear, consult with an elder law attorney. The American Bar Association also provides a checklist for choosing an assisted living facility.

6. Where is the Facility?

It’s nice to find a residence that’s close to friends and family, but experts caution against letting that be the deciding factor.

It is really important to have a place that’s easy to visit, but it’s more important to find a assisted living home that’s really good. Don’t choose a facility that’s five minutes closer to you, or 10 minutes closer to you just because of that. Make sure that you’re getting the best facility for what your loved one needs, and be realistic about what they need.

7. What Does the Ombudsman Say?


Because data on assisted living facilities can be hard to come by, experts recommend contacting the long-term care ombudsmen for your local area. These officials can offer additional checklists or information on any citations against a facility, as well as answer any additional questions you may have.

In terms of citations look out for any medication administration violations. Also ask “Have they been cited for not having staff trained, if it’s a state requirement, and have they gotten dinged for not having enough staff, again if that is a state requirement?”

For information on assisted living, contact Spring Arbor.

PBS.org