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Questions to Ask Prior to Admission into a Long-Term Care Facility

When considering placing a loved one into long-term care there are several questions you should ask the facility.

Will the facility honor my loved one’s durable power of attorney? If your loved one wants to withhold hydration and nutrition at the end of their life they need to know that the nursing home facility will honor their wish. There are facilities that will not withhold hydration and nutrition. These facilities may issue a discharge notice or send your loved one to the hospital if they choose to exercise this wish.

What is the restraint policy? Some nursing home facilities use restraints to treat a medical condition with a doctor’s order and other’s state they are restraint free. The facilities that are restraint free sometimes will say “our residents have a right to fall”. If a facility is “restraint free” they are still obligated to put fall precautions into place to prevent residents from falling.  Some of the fall precautions may include lowering their mattress to the floor or using a person safety device which will set off an alarm if the resident attempts to get out of their chair or bed.

What is the bed hold policy? Bed hold is the cost a facility will charge to hold a residents room while they are in the hospital. The facility usually charges the room rate per day to hold the room. So if a facility charges $180.00 a day then then bed hold would be $180.00 a day (even though the facility isn’t actually doing anything during this time!). You must agree to pay the bed hold each time your loved one goes in the hospital. If the facility fails to ask if you want to pay the bed hold they cannot charge you.   This is often an area that facilities are sloppy about following protocol on, and should be monitored if your loved one enters a hospital.   If you do not pay the bed hold, the facility does not have to give you back that room, but must (under federal law) offer another bed if available, and if not put you on the top of a list to be readmitted.

Does the facility have a family council? The family council is a place where you can bring your concerns and expect to get some response from the facility. The facility is required to provide a space for family council and provide a staff liaison to hear and respond to concerns. Family council is also a good support group for families.

What is the wait list for Medicaid? You will want to know how long the wait is for Medicaid and how many Medicaid beds the facility has. This will give you an idea on if there will be a Medicaid bed available when you need one. If one is not available you may have to move to another facility. If a facility tells you that they will have a Medicaid bed available when you need one DO NOT believe them. They cannot kick someone out to make room for another resident.  Most of the time you hear this when a resident has a large amount of money and the facility is interested in having them spend it at their facility.

Knowing the answers to these questions will better prepare you for what’s to come once your loved one is placed. The best thing you can do is be an informed consumer!   For our life care planning clients, assistance in selecting a facility is part of the services that are included in you working with us. Call our St. Charles office at 636- 486-9009 for more information.