When a senior and family make the big decision to consider moving to senior housing, evaluating the choices can be daunting.  We have several resource articles and fact sheets on different levels of care in senior living and will be covering more of your questions on this topic in upcoming posts.  Today we offer some valuable information that can help you more clearly evaluate assisted living facilities.

Florida’s Agency for Healthcare Administration (AHCA) describes assisted living facilities as places “designed to provide personal care services in the least restrictive and most home-like environment. These facilities can range in size from one resident to several hundred and may offer a wide variety of personal and nursing services designed specifically to meet an individual’s personal needs”.  The state licenses and regulates assisted living facilities.  They can operate under a standard license or specialty licenses which permit them to provide some additional services designed to help residents “age in place”.  Each state regulates their own healthcare and senior living facilities, so check with your state about regulations, oversight and service levels.

You can find the Florida AHCA Assisted Living Unit information online.  FloridaHealthFinder.gov is Florida’s healthcare facility portal, offering a search tool for assisted living facilities, home health care agencies and other providers.  You can use the search tool and then click on the specific facility to see details such as license, owner/administrator, contact information, and inspection reports.  Most states are offering this information online now for greater consumer transparency.

Here is a checklist, as well as tips and resources, that you can use as you evaluate assisted living facilities:

1. Review Aging Wisely’s free guide to “Choosing an Assisted Living Facility“.  This concise one-page overview gives you a road map for how to approach the search–where to begin, how to prioritize and what factors can help you narrow the search. (As an example of why this is so vital, a quick search for all assisted living facilities in Aging Wisely’s home county shows 205 facilities.)
2. Understand your state’s regulation of assisted living facilities and what services are permitted.  Make sure the facility posts its license and provides its most recent survey information.  You can likely also do some research on this online before you get started to weed out any facilities with negative reports.
3. Now you need to get beyond the survey, which is really only a regulation tool to identify problems and sanction providers who do not meet essential requirements.  It is vital to understand the management of the facility–its history and service, daily life and how well the facility operates from basic safety needs through life enrichment.  There are a number of checklists for visiting assisted living facilities, but here we have provided you with some additional tips on getting the whole picture:

• How interested is the staff in you/your circumstances?  Do they focus on “selling” the facility to you without finding out about your needs/if the facility is really a good fit for you?
• Talk to more than just the marketing staff.  Successful sales and marketing professionals do a great job welcoming you and portraying all the great things about their assisted living community, but you need to know the staff who you will be dealing with more closely after you move.  Ask to meet some of the management team such as a Director of Nursing/Nursing Supervisor, Resident Services Personnel and some care staff. 
• Are staff open and willing to help?  Are they bothered by your request or rushed with you?  Do various staff offer to help or greet you when you are visiting?
• If you can meet and ask some questions of the care staff, you might want to ask questions like: what do you like most about your job, what is the hardest part, how long have you worked here/how or why did you get in to this type of work and what is the best thing about this facility.  You can ask positive questions that will not necessarily make the person feel they are “on the spot” to reveal anything bad about the facility, but the answers may often be revealing in their own way.
• Similarly, when talking to management and marketing staff, ask some less common questions.  Talk to them about how they help with the adjustment period, what residents or families say is the one best thing about the facility or the hardest thing to get used to, or to give a recent example of a resident problem and how they resolved it.
• Make several visits at different times.  Facilities often invite potential residents for a meal, which is a nice way to check out the food.  However, it’s also great to ask to attend an activity and come by at various times to see how things operate throughout the cycle of the day.
• Cleanliness and upkeep can be outward signs of good management.  Bad smells or major housekeeping or maintenance issues are potential warning signs.
• Get recommendations and talk to others (residents, family members, friends who have evaluated facilities for their loved ones, trusted professionals).  However, take input with some caution–others may have very different circumstances or expectations than yours.
• You may need to rethink perceptions/priorities.  Sometimes families (and potential residents) get “hung up” on the room size, especially when moving from a large home.  Assisted Living Facilities are generally designed with your room(s) being more like your bedroom at home, with common living/dining/activity rooms, so it is a shift in thinking.  The room may be important, but quality care and other factors trump square footage when it comes to the reality of life in assisted living.

As you can see, the process of thoroughly evaluating assisted living facilities to make this major life decision can be daunting.  Many families find the help of a professional geriatric care manager invaluable in this process.  Not only can a care manager assess your needs to ensure a good fit and the correct level of care, but he or she knows the facility “beyond the inspection”.  Often the care manager (or team members) are working with current residents and get to see the day-to-day operations.  But, even when that is not the case, the care manager’s expertise in helping elders through such transitions and advocating for assisted living residents provides you remarkable insight during the process.

There are different options for services that can help you evaluate assisted living facilities, including referral services which do not charge you.  When considering these options, make sure you understand the parameters and experience/expertise of such providers.  Typically, referral services are paid through a marketing arrangement with the assisted living facilities, whether a referral fee (which is not allowed by many states, such as Florida) or some other arrangement.  This may limit which facilities are promoted to you.  Additionally, you want to know the background and knowledge of the provider and their experience particularly in working with assisted living residents.  Last, find out what the professional’s role can/will be during and after the transition.

A geriatric care manager is: hired by you as your advocate only, paid by the client/family and not marketing arrangements, able to help you negotiate and show you a range of options as appropriate to you, and available to help with any/all aspects of the transition and ongoing oversight and troubleshooting.

Need help evaluating assisted living facilities in the Tampa Bay area?  Looking for an assessment to determine best care options?  Just want to talk to someone about your situation and how to get started?  Call us at 727-447-5845.