Choosing a Facility

A few tips and things to keep in mind and ask about when making your decision:

• Go back unannounced several times, including mealtimes, evenings, weekends, and around shift-change time (3pm).

• Take note of what staff are doing before they have noticed that you are there. How are they interacting with residents? Are they wearing name-tags? Are they wearing masks correctly if masking is currently mandatory?

• If possible, speak with current residents and any family or friends who may be visiting.

When speaking with administration:

• Ask what services are included in the rate you will pay, how and when they determine/reassess the services you/your loved-one will need, and the cost of additional services offered.

• Ask how staff assignments are made and if the same aides will be assigned to your MIL consistently.

• Discuss your/your loved-one's needs, and any preferences or routines that are important to you/them, like staying up late at night or eating breakfast late. Ask how staff will meet those needs, preferences, and routines.

• Ask about and try to observe the activities offered--do they seem meaningful and engaging? (eg. gardening, community service, and chair yoga vs. "ice cream social" and "Sunday matinee")

• If relevant, ask about how roommate determinations are made, and how choices and conflicts are managed.

• Ask how residents are empowered. Is there an independent resident council? How are resident complaints addressed? What have been some recent resident complaints that have been resolved? 

• How are families supported? Is there a family council?

• Ask about COVID prevention and management.

• What safety measures do they have in place for when a resident needs emergency assistance? In what instances paramedics are called/residents are sent to the hospital.

• Find out if the facility accepts Medicaid and whether they will guarantee in writing that you/your loved-one can stay after "spending down" and switching to Medicaid. 

• Ask if the facility requires you to sign a mandatory pre-dispute arbitration clause or agreement in order to be admitted. “Pre-dispute” arbitration means you must agree to arbitration before any dispute – including abuse or neglect – arises. If possible, choose a facility that does not require you to sign such clauses/agreements.

• Consider looking at recent inspection reports from RIDOH and CMS CareCompare (not always useful or informative because many deficiencies go uncited).

• See if the facilities you are considering are represented in this spreadsheet of the worst deficiencies ("Immediate Jeopardy") in 2021-23. Note this includes nursing homes only, as assisted living facilities are not regulated in the same way as nursing homes.