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Senior Citizen's Guide to Baltimore

Ten Ways to Choose the Right Residential Long-Term Care Environment

Currently, according to the U.S. Department of Health and Human Services (HHS), an estimated 9 million Americans over the age of 65 need long-term care, which can include assisted living or skilled nursing home facilities. The demand for long-term care is expected to increase, with HHS forecasts showing that nearly half of Americans who reach the age of 65 will enter a nursing home at some point in their lives. 

People choose a skilled nursing facility, or nursing home, when they need help caring for themselves, either short-term, such as after an illness or injury, or longer-term, in the case of chronic illness or a disability. These facilities are designed to provide nursing and medical care while maximizing the resident’s independence.

It’s important to plan for your (or your loved one’s) long-term care as early as possible. Too often people find themselves in crisis and don’t know where to turn for help. As a result, they may not be receiving the best care possible because of the last-minute rush.

Selecting the right environment and the right care is a critical step in placing your mind at ease when you move into this stage of life. To help you prepare for this important decision, here are the top-ten factors to consider when you visit and evaluate a nursing home:

  1. Certification – Is the provider certified, licensed or accredited? When was their last state survey conducted, and what were the outcomes?
  1. Longevity How long has the provider served the community?
  1. Accessibility Are there registered nurses available 24 hours-a-day, seven days-a-week? Is transportation available for doctor visits, shopping, activities, etc.?
  1. Facility – Is the facility well-maintained, clean and well-lit? Is it home-like with rooms containing personal items such as pictures, TV, books, etc.? Are arrangements made for residents to spend time outside?
  1. Residents – Do the residents look clean and well-groomed? Do they spend time with each other and appear happy and comfortable? Do the administrators and staff call the residents by name and interact warmly with them?
  1. Staff – Are staff members friendly and outgoing? Are resident requests for assistance answered promptly? What types of background checks are conducted before hiring staff?
  1. Health care – Is self-administration of medication allowed? How often does the physician visit? Are other providers (nurse practitioners, physical therapists, etc.) involved in residents’ care? Will the provider honor the resident’s living will or advance directive?
  1. Food – Are there set times for meals? Are residents able to select from a menu?  Does the food look appetizing and do residents appear to enjoy their meals? Are cooking facilities available for resident use?
  1. Activities – Are individual and group activities offered? Does the activity list seem varied and include things that your loved one would enjoy? Are pets allowed to visit?
  1. Finances – What services are covered with the “basic” charge? Are there added costs? What are the billing, payment and credit policies? When may a contract be terminated and what are the refund policies?

Take advantage of the time you have and prepare for your or your loved ones’ long-term care. For more information on selecting a nursing home, including “The Inside Guide to Evaluating Skilled Nursing Facilities,” go to

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