How to Choose a Nursing or Assisted Living Facility - Podcast Transcript

Recorded: November 16, 2012

Narration: Welcome to Fairfax County’s News to Use about Long-Term Care, the podcast that brings you consumer information as well as information on protecting the rights and quality of life of those living in nursing facilities and assisted living facilities.  

I’m your host, Jim Person.

On today’s show, we will discuss what you need to know about choosing an assisted living or nursing facility.

Opening Music:

Part 1

Jim: Joining me today is Beth Ann Margetta, an ombudsman with the Northern Virginia Long-Term Care Ombudsman Program.

Welcome, Beth Ann.

Beth Ann:  Hi, Jim. It’s great to be here.

Jim:  Beth Ann, give our listeners a brief description of what your program does and who it represents.

Beth Ann:   Sure, Jim. The Northern Virginia Long-Term Care Ombudsman advocates for residents of nursing and assisted living facilities when they have a concern about their care or if they feel that facility staff has not respected their rights.

We work with the resident or the resident’s family and the facility to resolve the complaint.

We also provide training and consultation to staff and we provide consumer information on long-term care to the public.

Jim:  And that is why you are here, today, to tell us what we need to consider when choosing an assisted living or nursing facility for ourselves or a family member.

So why don’t you begin by telling us the difference between the two.

Beth Ann:  Ok, Jim. An assisted living facility provides care to people who require some assistance completing daily tasks, or what we call "activities of daily living." Nursing facilities provide care to people who require more extensive assistance with these activities and 24-hour nursing care or supervision.  Both are regulated by the Commonwealth of Virginia.  Assisted living facilities are licensed by the Department of Social Services and nursing facilities are licensed by the Department of Health. Nursing facilities that receive Medicare and Medicaid are also regulated by the federal government.

Jim:  OK – I get the difference but I may not know which one is right for me or my relative. How do I figure this out?

Beth Ann:  First, you have to determine the amount of supervision and care she would need.

This is what we call the "level of care." The level of care is dependent on how many activities of daily living, or "ADLs" the person can perform. Examples of activities of daily living are bathing, dressing, walking or ambulation, toileting, being able to feed yourself and transfer, for example getting out of a wheelchair and into bed.

Nursing facilities generally provide a higher level of care than assisted living facilities.

Jim: So, let’s say I call the Long-Term Care Ombudsman Office about my 85-year-old father who has been living alone at home but is now in the hospital after falling and fracturing his hip. I know he has fallen before, I know he has memory issues and now the hospital nurse is saying he needs 24-hour care. What would you tell me?

Beth Ann:  In this situation, we would know by the phrase "24-hour care" that he needs a nursing facility level of care.

Jim:  Ok, how about if I call you because my 90-year-old aunt seems to be doing fine but is having difficulty with the stairs in her home and having problems making her meals and taking her medication on time?

Beth Ann:  Your aunt would probably need an assisted living facility but you would have to have an assessment done. We would recommend bringing her to her primary physician for an assessment of her level of care, establishing her physical and cognitive abilities and needs.

Once we know the recommended level of care, then we can discuss services and supports and who to call to help with a long-term care facility placement. In this situation, she may be able to stay in home with supports, but that’s for another conversation.

Jim:  Let’s say, I know what kind of facility I need, how do I choose among the various facilities in the area?

Beth Ann:  First, we recommend touring the facilities to experience the environment and get a sense of community. While there, we recommend you be aware of your five senses – in other words, the sights, sounds and odors you are aware of while there. For example, are the residents well-groomed and dressed appropriately, are the halls odor-free, and is there a home-like environment? These are all environmental indicators of good care.

We have a publication posted on our Web page called Tips for Caregivers that you should bring along with you.

Break:  Thank you Beth Ann; let’s take a quick break.  When we return, Beth Ann will discuss various online consumer resources at your disposal to help select a facility as well as her program’s Complaint Log and how to use it.  Stay tuned!

Transition:  Sound Effect

PSA: Audio from Fire Prevention PSA.

Transition:  Sound Effect

Part 2

Jim:  So Beth Ann, we discussed, in the first section of the program how to establish whether I need an assisted living facility or a nursing home and the need to tour the facilities before choosing. Assuming I’ve narrowed down my selection, can I call your office for a recommendation?

Beth Ann:  We get that question a lot. We can’t endorse or recommend specific facilities, but we encourage consumers to consult our complaint log. This is a list of all of the formal investigations completed by our program in the last 12 months.

It doesn’t specify details about these cases, but it does show if we had a case at a particular facility, if the concern was verified by an Ombudsman, and if it was resolved to the complainant’s satisfaction.

The Complaint Log is a great resource for consumers to use to get a sense of what issues were occurring at specific facilities in the region. It is posted on our Web page.

Jim:  And I understand the federal government also has a consumer Web page.

Beth Ann:  Yes it does., the official government site for Medicare, enables consumers to review ratings on nursing homes with a feature called Nursing Home Compare.

When you go to the Web page, you should look for the link labeled, finding Nursing Home Care. This brings you to the Nursing Home Compare page.  

This feature lets you select facilities to compare their quality rankings based on a five-star rating system. The stars are awarded on the basis of health inspection results, staffing, and quality of care measures.

Jim:  Sounds easy. That feature only works for nursing homes, is that correct?

Beth Ann:  Yes, Medicare does not pay for or regulate assisted living facilities so Nursing Home Compare is only for nursing facilities.

Jim:  I understand your program covers all of Northern Virginia, is that correct?

Beth Ann:  Yes it does, Jim. We cover the counties of Arlington, Fairfax, Prince William and Loudoun, as well as the City of Alexandria and all the jurisdictions within these jurisdictions. There are 33 nursing facilities and 86 assisted living facilities in Northern Virginia serving approximately 11,204 residents.

Jim:  Thank you for being with us Beth Ann. For more information on Resident Rights or consumer information on long-term care, contact the Northern Virginia Long-Term Care Ombudsman Program at 703-324-5861, TTY 711. 

Office hours are Monday-Friday, 8 a.m. to 4:30 p.m. You can also visit

Until we meet again, this is Jim Person for News to Use about Long Term Care.

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