www.CarePathways.com - CCRC Checklist First Impression Do you like the facility's location and outward appearance? Is the facility convenient for frequent visits by family and friends? Is the facility near a shopping, and entertainment complex? Can the resident access a medical complex easily? Is public transportation available/accessible? Are you welcomed with a warm greeting from the staff? Does the staff address residents by their names and interact with them during your tour? Do you notice the residents socializing with each other and do they appear content? Can you talk with residents about how they like living there and about the staff? Is the staff appropriately dressed, friendly and outgoing? Do the staff members treat each other in a professional manner? Are visits with the residents encouraged and welcome at any time? What percentage of the apartments has been rented and is occupied? Is there a waiting list? If so, how long do they estimate it will take to be admitted? Living Area and Accommodations Is the floor plan well designed and easy to follow? Are doorways, hallways and rooms accommodating to wheelchairs and walkers? Are elevators available for those unable to use stairways and handrails to aid in walking? Are floors of a non-skid material and carpets conducive for safe walking? Does the residence have good lighting, sprinklers and clearly marked exits? Is the residence clean, free of odors and appropriately heated/cooled? What is the facility's means of security if a resident wanders? Are the common areas in general attractive, comfortable and clean? Is there an outside courtyard or patio for residents and visitors and can they garden? Does the residence provide ample security and is there an emergency evacuation plan? Are there different sizes and types of units/housing available with optional floor plans? Are single units available and/or double occupancy units for sharing with another person? Does residence have furnished/unfurnished rooms? What is provided or what can they bring? May they decorate their own rooms? Is there adequate storage space? Is a 24-hour emergency response system accessible from the unit with own lockable door? Are bathrooms private with handicapped accommodations for wheelchairs and walkers? Do all units have a telephone and cable TV and how is billing handled? Does kitchen unit have refrigerator/sink/cooking element and can food be kept in their units? May residents smoke in their units or are there designated public areas? Moving in/Contracts and Finances What's involved with the moving in/out process? How is the initial needs assessment done? Does assessment process include the resident, family, facility staff along with the physician? Is there a written plan for the care of each resident and is there an ongoing process for assessing a resident's need for services and how often are those needs evaluated? Inquire as to what kinds of contracts are available to you. The CCRC contract is a legal agreement between you (the consumer) and a continuing care retirement community. This agreement generally secures living accommodations and services, including health care services, over the long term. Determine what fee structure and contract option best suits you. The three most common types of CCRC agreements are: Extensive contract: This offers unlimited long-term nursing care for little or no substantial increase in your usual monthly payments. Modified contract: This includes a specified amount of long-term nursing care beyond which you are responsible for payment. Fee-for-service: You pay full daily rates for all long-term nursing care required. Find out what the payment schedule is and if the residents own or rent their unit? What is the basic entrance charge, and what is included for that fee? What charges are extra? How much is the monthly fee? How often can it be increased and for what reasons? Is there a limit on the amount of increase per year? What is the history on monthly fee increases? Are refunds or rate reductions ever granted? Under what conditions? Are any portions of the charges covered under long-term care insurance that the resident may already have or be eligible for? Are there charges that are duplicated? What happens if a couple moves into an apartment and then one of them must go to the nursing home and/or dies? Will the other one be allowed to stay in the same apartment and how will this effect rates? What happens if someone wants to leave after just a few weeks or months, or if they die? Is any portion of the entrance fee refunded to their estate? What type of health and medical coverage is included in the entrance and monthly fees? Are dental work, vision exams and routine wellness checkups included? What determines when a resident is moved to a nursing care facility and who decides? Will the facility guarantee that nursing home care will be available on the premises, or nearby, when needed? What rates will residents be charged for such care? Do billing, payment and credit policies seem fair and reasonable? May resident handle his/her own finances with staff assistance if able? Must a family member/outside party be designated? Health/Personal Care/Services What type of healthcare and personal care services are available? Does the facility have both short and long-term services, such as routine physical and dental examinations and pharmacy services, as well as skilled nursing and therapy services? Can the facility provide a list of available services and are residents and families involved in developing the service agreement? Who provides these services/what are their qualifications? Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? ADLs include dressing eating, mobility, hygiene, grooming (bathing, toileting, incontinence) Does residence have programs for Alzheimer's, other dementias and other specialized areas? How are medical emergencies handled? Does the residence have a clearly stated procedure for responding to medical emergencies? Is there an arrangement with a nearby hospital? Will the staff dispense medication to able residents? If so, what are the dispenser's qualifications? Will they monitor residents taking medications? Are housekeeping, linen service and personal laundry included in the fees, or are they available at an additional charge? Are on-site laundry facilities available and convenient? Does the residence provide transportation to doctors' offices, the hairdresser, shopping and other activities desired by residents and can it be arranged on short notice? Are pharmacy, barber/beautician and/or physical therapy services offered on-site? Social and Recreational What kinds of group/individual recreational activities are offered and who schedules them? Is there an organized activities program with a posted daily schedule of events? Does the facility schedule trips or other events off premises? Are the resident activity (social) areas appropriate and desirable to the prospective resident? Do residents participate in activities outside of the residence in the neighboring community? Are there supplies for social activities/hobbies (games, cards, crafts, computers, gardening)? Are religious services held on the premises? Does the residence arrange for nearby services? Do volunteers and family members come into the residence to participate/conduct programs? Does the residence create a sense of community by allowing residents to participate in certain activities or perform simple chores for the group as a whole? Are there fitness facilities, as well as regularly scheduled exercise classes? Are residents' pets allowed in the residence? Does facility have pets and who cares for them? Staff Do the staff members have professional backgrounds in continuing care and geriatrics field? What are the hiring procedures and requirements for eligibility? Are criminal background checks, references, and certifications required? Is there a staff-training program in place and what does it entail? Is staff courteous to residents and to each other? Are responses for assistance timely? Is the administrator or appropriate staff person generally available to answer questions or discuss problems and would you be comfortable dealing with them on a daily basis? Does the facility have a volunteer program or is it affiliated with any student clinical program? Food What are the different meal programs offered? Does the residence provide three nutritionally balanced meals a day, seven days a week, and how does the menu vary from meal to meal? What about special diets; does a qualified dietitian plan or approve menus? Are residents involved in menu planning and may they request special foods? Are common dining areas available and when can residents eat meals in their units? Does dining room environment encourage residents to relax, socialize, and enjoy their food? Are meals provided only at set times or is there some flexibility? Are snacks available? How many meals are included in the fee? If a resident becomes ill, is tray service available? Can residents have guests dine with them for an additional fee? Is there a private dining room for special events and occasions, if desired? Licensure and Certification Is the facility accredited by the Continuing Care Accreditation Commission? Accreditation is not required and not all CCRCs are evaluated. Is the nursing center Medicare and/or Medicaid certified? What reputation does the facility have in the community? How long has it been in business? Is it in good financial health? Does the facility follow generally accepted accounting procedures? If the facility is sponsored by a nonprofit organization and managed under contract with a commercial firm, what are the conditions of that contract? Is there a resident council or organization through which residents/family have a means of voicing their views on the management of the community?