If possible, begin thinking about the possibility of choosing a facility before a crisis happens. There are many different kinds of facilities and you will want to take the time to find a facility that is a good fit for your loved one’s needs.

• Think about how the costs of a long-term facility can be covered.

  Medicare only covers a limited number of days in a Medicare-certified skilled nursing facility if your loved one meets certain health criteria. Medicaid is the nation’s largest payer of long-term care services. Some people rely on long-term care insurance or pay out of pocket.

  To find out when Medicare will pay for care in a skilled nursing facility and where else you can get help paying for a long-term care facility, click on the links in the GO TO box.

• Decide what kinds of services your loved one needs.

  Is she relatively healthy but needs help with cooking and cleaning? Does she need help remembering to take medications or managing a chronic condition (like diabetes)? Does she require 24-hour supervision? If she has been diagnosed with a terminal illness, she may qualify for Medicare’s hospice benefit, which covers extensive home health care.

  For tips on how to assess what kind of care your loved one needs, click on the link in the GO TO box

• Think about what features your loved one would prefer. Would she like to be near friends and family? Is she more comfortable in an urban or rural setting? Does she have language or cultural concerns?

• Make a list of facilities in your area. You can look to

  • your local long-term care ombudsman, an organization that advocates for long-term care residents;

  • Member of the Family, a group that provides consumer-friendly reports on nursing home inspection reports, and lists over 16,000 Medicare/Medicaid-covered nursing homes;

  • The National Citizens’ Coalition for Nursing Home Reform, an advocacy group for people with long-term care needs;

  • Medicare, which has an online nursing home comparison tool.
  To access the web sites of these organizations, click on the links in the LINKS box.

• Before you visit
  Call facilities that interest you and ask whether they fit your basic service criteria. Then narrow down your list of facilities and make appointments to visit.

• When you visit
  First, check to see that the most recent Department of Health inspection report is publicly available. If you do not see the report, ask for it. It will list any problems found in the facility and the facility’s plans for improvement.

• Also take note of

  • interactions between staff and residents;

  • residents’ appearance;

  • cleanliness;

  • building safety features for residents (lighting, accessible elevators, handrails, etc.);

  • respect for residents’ privacy;

  • quality of different rooms (ask to see a variety of living options).