How to Choose a Safe Long-Term Care Facility


Offered by Armando Edmiston, Esq.

Know the warning signs of a dangerous environment

As an attorney who represents victims of nursing home and assisted living abuse and neglect, I’ve seen firsthand many facilities that put their residents at risk. Too often, when families are making tough, painful decisions to place a loved one in a facility, warning signs are swept under the rug, overlooked, or explained away. The consequences can be dire.

If you’re considering a long-term care facility, you need to do your due diligence and assess the facility for safety. Here’s what to look for.

First, look at the physical condition of the premises.

From the moment you arrive at an assisted living or other senior living facility, pay attention to the physical condition of the building. That starts before you even go inside: Are the grounds landscaped and well-maintained? Do you see cracked windows or other maintenance issues from the outside? When you enter the building, look to see if it’s clean and brightly lit, and whether stairs and railings are well-maintained.

The physical condition of the premises is important for two reasons. First, maintenance issues can directly affect safety. Dim lighting often contributes to slips, trips, and falls, for example, especially among seniors with declining eyesight. Spills and trip hazards need to be cleaned up promptly to avoid falls. In short, failure to properly maintain the premises is itself a form of neglect.

Second, if the staff are not properly maintaining their facility, that’s a red flag that they may not be properly caring for residents either. Maintenance problems often go hand in hand with understaffing, poor training and supervision of staff, and generally dysfunctional facilities.

Pay attention during the check-in process.

Senior living facilities are responsible for security on their premises. If you visit a facility in person – and it goes without saying that you should always visit a facility in person before placing a loved one there – you have the opportunity to experience their security protocols firsthand.

Are staff checking IDs? Do they keep you within eyesight while you are visiting? Are there visible cameras or other security systems? Visitor-on-resident abuse is a real threat in senior living facilities, so make sure the facility you’re considering takes that threat seriously.

Observe and listen to the people there.

Pay close attention to the people working in the facility. Do they seem tired or well-rested, frustrated or upbeat? If they appear overworked or overly stressed, that’s at the very least a yellow flag – care work is certainly tiring under the best of circumstances, but it shouldn’t be to the extent that staff are constantly burned out and unable to provide quality resident care.

It’s also worth asking how long key people at the facility have been there, such as the director and heads of departments. Some degree of staff turnover is normal in senior living, but if multiple key positions have turned over in the last year, that could be a sign of a problem.

Likewise, pay attention to the current residents. Do they seem well cared for? Are they clean, well-groomed, and appropriately dressed? Will they talk about their experience? Are their interactions with the staff warm and positive? Abuse and neglect are often subtle, but you can usually get some sense that something is wrong. Follow your gut.

Ideally, make multiple visits in person.

The best way to get a sense of a senior living facility is to visit it more than once, on different days of the week and times of day. If possible, go to the facility during a mealtime so that you can see the dining facilities in action. In addition to the overall quality of the food and cleanliness of the dining area, see whether the residents have a choice of food items at each meal, whether the facility can accommodate special dietary needs, and whether staff help residents eat and drink.

Visiting at multiple times also allows you to meet other staff members and observe different activities in the facility. The broader your perspective on the assisted living facility, the more likely you are to see any safety red flags.

Ask about their policies to prevent and handle abuse and neglect.

Assisted living management has a responsibility both to prevent abuse and neglect from happening in their facilities, and to respond appropriately when acts of abuse or neglect do occur. Meet with the director of the facility and ask about their hiring process – do they conduct background checks and make sure they don’t hire staff with a history of mistreatment of residents? – as well as their procedures on prohibiting and reporting abuse and neglect. Look for any information you can find on how the facility handles reports of safety concerns.

Of course, don’t just take the facility’s word for it. Check Medicare.gov and your state health agencies for any recent citations related to abuse and neglect. Check the local media in the town where the assisted living facility is located, too. If the facility has a history of harm to residents and there hasn’t been significant change since then, look elsewhere.

Compare multiple facilities.

It’s hard to get a sense of whether a particular senior living facility is the right fit for your loved one if you haven’t looked at other facilities to have a point of comparison. It’s always worth taking the time to check out multiple facilities in your area to look for the right fit. In addition to safety, take into account your goals, your values, and your loved one’s particular needs. This is a highly personal decision, and you need a broad perspective to get it right.

Make sure you can stay actively involved in your loved one’s care.

No matter how good a facility looks during the placement process, it’s always possible for things to go wrong after your loved one moves in. It’s possible that the facility managed to cover up warning signs despite your due diligence, or that a change of management or staff will cause problems to crop up that weren’t present when your loved one moved in. Evaluating a facility for safety isn’t something you do once; it’s an ongoing process.

This is why location is critical when choosing a facility: you want to make sure you can visit regularly and stay actively involved in your loved one’s care. Feel free to ask the facility management about this, too. Will you be able to visit frequently, at different times of day and on different days of the week? Good facilities should welcome involvement from residents’ families. Facilities that unreasonably restrict visitation are best avoided.

Remember, your loved one has legal rights.

Senior living facilities are required by state and federal law to maintain sufficient staffing levels and provide quality care to their residents. Good facilities follow the law and take their contractual responsibilities seriously. Facilities that don’t follow the law and allow their residents to be harmed can be held legally responsible by residents and their families.

Both during and after your loved one’s placement in an assisted living facility, you need to stay involved. Keep your eyes open and raise any safety concerns as soon as you see signs of trouble. If you believe your loved one may have been abused or neglected, report it right away – and consider talking to an experienced attorney in your area about your options.

Armando Edmiston is an assisted living abuse and neglect attorney in Tampa, FL.

26 Jul 2021