Recently, I had coffee with my friend David. David’s mother had been living in Alabama, close to David’s sibling, but when that sibling moved out-of-state for a new job, Mom decided she’d like to move closer to David and his family. The plan: to move to a senior living community.

David was fortunate that, in his work as a CPA for the nursing home industry, he had intimate knowledge of what to look for in this particular situation. Here are the steps he took in his research to find the best living situation for his mom:

Step One: Start with Reliable Research:

David went online and used the Medicare website (https://www.medicare.gov/care-compare/) to see and compare nursing home facilities in the local area. He was also looking to see if the nursing homes were part of a continuing care retirement community (sometimes also referred to as a Life Plan community.) These communities typically offer multiple housing options such as independent living, assisted living, skilled nursing care facilities and even memory care units.

Step Two: Dig Into the Details:

After identifying nearby facilities with strong 4- or 5-star Medicare ratings, David looked deeper into the reports. These provide an impressive amount of information, such as:

·         Health inspections and compliance history

·         Staffing details, including staff-to-patient ratios and turnover rates, compared with state and national averages

·         Resident quality measures (flu shot rates, pain management, fall-related injuries, weight loss statistics, etc.)

·         Ownership history, including how long the facility has been under current management

This data gave him an objective foundation before scheduling any visits.

Step Three: Visit in Person:

David went to the websites of the facilities he was interested in. If he continued to be impressed, he made appointments to tour the facilities. Once there, he asked a number of questions:

• Please share a couple of the most important things the facility is working on right now.
• Please tell me about staff turnover in direct care (RN, LPN, CNA), indirect care (dietary, laundry, housekeeping), and especially with regard to upper management and department heads. 
• How safe is the environment (emergency call systems, fall prevention, security)? 
• What is something that has gone seriously awry at the facility, and how did staff address this?
• What meals are provided, and how are dietary needs accommodated? (His mother is a picky eater.)
•  What is the monthly cost, what does it include, and what additional services cost extra? What kinds of activities and programs are offered to support social, physical, and emotional well-being?
•  What do you think the staff is most proud of when they come to work every day?
• How do you help new residents adjust and feel part of the community?

Step Four: Trust Your Eyes and Ears:

He also keenly observed how staff interacted with residents, whether people looked engaged and well-cared-for, the general atmosphere of the place, including how it smelled, and whether it seemed like a community his mother would be comfortable in.

 In follow-up questions, David made sure to gain clarity about the following:

·         Finances over time: What happens if your parent’s financial situation changes?

·         Future transitions: Can your parents stay within the same community if their care needs increase?

·         Visiting policies: How flexible are visiting hours for family and friends?

·         Resident and family feedback: He was able to talk to current residents and their families about their experiences.

David’s approach was thorough, and it bore fruit. Earlier this year, his mother moved from Alabama to Oregon and was delighted by both the lack of humidity and the lack of a sales tax. She enjoys the facility David chose for her. But most of all, she’s pleased to be nearer to her son, daughter-in-law and grandchildren.