Continuing Care Residence Checklist

Directions: This checklist is intended for use when selecting a continuing care community. Complete this for each facility you visit to keep track of and compare different facilities.

Name of Facility:

Date of Visit:

Address:

Phone Number:

Contact:

Basic Information Yes No Comments
Is facility Medicare-certified?
Is facility Medicaid-certified?
Does facility have state license? Is it posted?
Is the latest state survey or inspection report available for review?
Has the facility corrected all deficiencies (failure to meet a federal or state requirement) on its last inspection report?
Has the license ever been revoked? If so, why?
Is there a waiting period for admission for any levels of housing?
How many independent living apartments are there?
How many intermediate nursing beds are there?
How many skilled nursing beds are there?
Are special services (e.g., dementia, ventilator, rehabilitation) needed offered in a separate unit?
Are the nursing facilities located on the premises? If not where?
If one spouse needs to move to a nursing bed for more medical care, can the other remain in the apartment at no extra cost? If no, what charges apply?
Is the facility nearby shopping, medical services and/or entertainment?
Is facility located close enough to friends and family?
Financial and Legal Contract Yes No Comments
What is the base monthly fee for each level of care?
What services are included in that fee?
Is any of the cost eligible for coverage under Medicare, Medicaid, another financial aid program or private insurance?
Is a deposit or entry fee required?
Is any of the entry fee or deposit refundable due to death or other issues within a certain period of time?
Are there any refunds or credits for leaving for a vacation or entering a hospital?
If resident is hospitalized or placed in other care, how long will his or her bed held? At what fees or charges?
Are payment plans available?
What are the additional services available and at what costs?
What is the procedure for when fees are changed? Who is notified?
Is there an internal appeal and/or grievance process? Are issues handled in a timely manner?
What are the eviction procedures?
Who has the authority to move a resident to a nursing bed if he or she becomes too confused or ill to care for him or herself? What are the procedures?
Are residents with Alzheimer's or dementia accepted for admission?
Are residents with mental health problems (depression) accepted for admission?
Who is responsible for repairs or replacement after spills or accidents that destroy either the facility or resident's property?
Does the facility offer a separate insurance policy that covers residents' personal property?
Is the resident required to hold a renter's insurance policy?
Do residents have to purchase a long term care insurance policy?
Are the premiums included in the regular monthly fees?
Personal and Health Care (Note: some of these questions only apply to nursing facilities.) Yes No Comments
May residents still see their own doctors?
Will the staff set up appointments for residents?
How will physician and facility communicate about resident's care?
Does the facility have an arrangement with a nearby hospital for emergencies?
Can the resident use another hospital?
Does the facility call family or a personal doctor when emergencies arise? Under what circumstances?
Are assessments performed on residents to assess needs? How often?
Does facility have the ability to determine the cause of confusion a resident may develop (medications versus diagnosis of dementia or Alzheimers')?
If the resident needs additional care, can he or she stay in the apartment? What services are available and at what cost?
Does the facility have the ability to deal with a resident's behavior that may change and become abusive?
Do residents receive preventative care such as yearly flu shots?
Does the facility monitor residents' health including routinely monitoring weight?
Does the staff routinely check each resident thoroughly from head to toe to avoid bed sores?
Are there health care facilities available at the facility (physical therapy, occupational therapy, wound care, hospice care, social services, etc.)?
Are there a variety of medical services available (dentists, podiatrists, optometrists)?
Does the facility use physical or chemical restraints? If so, under what circumstances and policy?
Is there a beauty parlor or barber?
Are there laundry services? Is there an extra cost?
Medications (Note: some of these questions only apply to nursing facilities.) Yes No Comments
Are there any limitations on how the staff will handle your relative's medications?
Are there safeguards in place to ensure that medications are taken on time and in the correct dosage?
Is a pharmacist available for individuals and staff?
Are routine and emergency drugs available? How are prescriptions filled? What are the costs?
Who dispenses medications?
Who reviews medication procedures and how frequently?
Plan of Care (Note: some of these questions only apply to nursing facilities.) Yes No Comments
Does the facility prepare a written plan for how it will care for the resident?
Are Certified Nursing Assistants involved in care planning meetings?
Are care plan meetings are held with residents and family at convenient times if possible?
How will my family be involved in the plan?
What if I don't agree with the plan?
What involvement does a confused resident have?
Does the plan cover all aspects of a resident's life? (physical, mental, social and medical)
Are the plan and any medical records stored? If so, is confidentiality guaranteed?
Does a pharmacist review individual drug treatment plans?
Residents (Note: some of these questions only apply to nursing facilities.) Yes No Comments
Are residents encouraged to be as independent as possible?
Are residents clean, appropriately dressed for the season or time of day and well groomed?
Are residents interacting with each other? Do they look content and engaged?
What is the average age of the residents?
What do residents like best? Least?
What is daily life like?
Are most residents at the same level of mental function as your loved one?
Is there a resident and/or family council? How often does it meet? Has the council taken any action recently?
Are residents' rights posted? Does the facility follow a resident's bill of rights?
Do residents have the right to come and go as they please?
Is mail delivered promptly and unopened? Can residents have subscriptions to magazines and/or newspapers?
Environment Yes No Comments
Are there any overwhelming unpleasant odors?
Is the facility clean and well-kept?
Is the temperature comfortable for residents?
Is facility well lit?
Are there quiet and/or private areas for visiting with friends and family?
Are noise levels in common areas comfortable?
Is smoking not allowed or is it restricted to certain sections of the facility?
Are furnishings comfortable, sturdy and attractive?
Are the building and grounds well cared for and attractive?
Staff Yes No Comments
Is the staff visible?
Does the staff wear name tags?
Does the relationship between staff and residents appear to be polite, warm and respectful?
Is the staff friendly, considerate and helpful?
If residents or staff not native English speakers, can they communicate effectively with each other?
Does the staff have good morale?
Does the staff refer to residents by name and knock before entering a resident's room?
Does the staff respond quickly when residents push the call buttons?
Is training and continuing education programs available to all staff? What are trainer's qualifications?
Does the staff receive abuse prevention training?
Are background checks completed for all staff?
Does your guide providing the tour know residents' names and is recognized by residents?
Is there at least one full-time registered nurse (RN) on duty around the clock in addition to the Administrator or Director of Nursing?
Who is Director of Nursing?
Does he or she hold a current state license?
Is the administrator or Director of Nursing available to answer questions, hear complaints, or discuss problems and concerns?
Does the same team of nurses work with same residents most days of the week?
How long are shifts?
Is the ratio of Certified Nursing Assistants to residents reasonable? How many during the day? At night? On weekends?
Is the ratio of aides to residents reasonable? How many during the day? At night? On weekends?
Is the staff expected to handle emergencies? How are they trained?
Is there at least one full-time social worker on staff? What services does he/she provide?
Is a licensed doctor is on staff, on site daily and can be reached at all times? What hospital is he or she affiliated with?
Has the management team worked together for at least one year?
Residents' Room and Apartments (Note: some of these questions only apply to nursing facilities.) Yes No Comments
Is the living space big enough?
Is it well lit?
How often is it cleaned?
In the apartments, what furnishings are included?
Can residents have personal belongings and/or furniture in their rooms in the nursing facilities?
Does each resident have storage space in his or her own room or apartment?
Do residents have access to a personal telephone, Internet and television?
Is there a cable TV connection in each room?
Do policies and procedures exist to protect residents' possessions?
Are doors shut when a resident is being dressed or bathed?
Are water pitchers within a resident's reach?
Are call buttons near each bed or do residents wear a device instead?
Is there a private bathroom? If so, how often is it cleaned?
Is there a call button in the bathroom?
Are the rooms private or shared? If shared, do residents have a choice of roommates?
How many roommates to a room?
Is there a privacy curtain around each bed or between beds?
What is policy if roommates are not getting along with each other? How does facility deal with problems when they arise?
Menus and Food Yes No Comments
How many meals are served a day?
Do residents have a choice of food items at each meal?
Is the meal schedule flexible? At what times are meals served?
Are favorite foods offered?
Does the food look and smell good?
Are special dietary needs accommodated? How?
Are nutritious snacks available upon request?
Can staff help residents eat and drink at mealtimes if needed?
Does a nutritionist or dietician review meals and special diets?
Can a meal tray be delivered to a resident's room? At what cost?
Is the food preparation separated from the dishwashing and garbage areas?
Is food requiring refrigeration properly stored?
Do the kitchen workers observe sanitation rules?
Activities Yes No Comments
Are residents, including those who are unable to leave their rooms, able to choose to take part in activities? Are residents encouraged, not pushed, to participate?
Are activity schedules varied and include resident's interests? Do residents provide input?
Is there someone who develops and supervises recreational activities? What is his or her background?
Is reading assistance available?
Does the facility have pleasant outdoor areas for resident use? Patios to garden? If necessary, does the staff help residents go outside?
Are there protected/enclosed areas for residents with dementia?
Are residents involved in the community (e.g., volunteering) outside the facility? If so, how? How is staff involved?
Are there recreation facilities on site (such as a game room)?
Can residents exercise? What are the exercise facilities like?
Does the facility have an active volunteer program? Are volunteers from the community? Are they screened?
Are dogs and/or cats allowed?
Are birds or other small animals allowed?
Does the facility have pets? Or can family pets come with visitors? If yes, what are the restrictions?
Does the facility accommodate religious or spiritual needs?
What is the visiting policy?
What is the overnight guest visiting policy? For adults? For children?
Safety and Security Yes No Comments
What kind of security is provided?
Are apartment residents given their own key for internal security?
Are there others that have a key to the apartment? Who?
Is there a security checkpoint at the entrance?
Does the facility meet local, state and federal fire codes?
Are emergency exits clearly marked, accessible and easily opened from the inside?
Are there fire safety systems? (For example, smoke detectors, fire extinguishers and sprinklers are in each room.)
Is there an emergency evacuation plan? Is it posted?
Does the facility hold regular fire drills that include bed-bound residents?
Are the facility's doors locked? When? Are exit doors alarmed?
Are there safety locks on windows?
Are there handrails in the hallways and grab bars in the bathrooms?
Are stairway doors kept closed to prevent potential spread of fire?
Is the facility wheelchair accessible? (Example: hallways are wide enough, there are wheelchair ramps)
Is floor covering made of nonskid material?
Is the building generally free of clutter?
What safety measures are in place to protect residents from wandering?
Is there an emergency generator or alternate power source?
Are there written policies about when 911 is called and who decides to call?
Transportation Yes No Comments
How does the facility handle transportation for appointments?
What are the costs involved in using their transportation?
Is transportation wheelchair accessible?
Is transportation available for non-medical appointments such as shopping and cultural events?
Is there parking available?
Do residents get an assigned parking space?
Is there public transportation nearby?
General rating on a scale of 1 (poor) to 5 (excellent):

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