How to Choose the Right Senior Care Community
Hello, and this is Ben Souchek with Home Downsizing Solutions. And thank you for joining us today for our interview series for Home Downsizing Solutions. And today I have a great guest with us, Steve Kuker with Senior Care Consulting in Kansas City. How are you doing today, Steve?
I’m doing well, thank you. And thanks for the opportunity Ben, I appreciate it.
Absolutely. I just wanted to thank Steve again, we are having a series of videos for senior care and information about senior care living and senior care communities. So if you haven’t checked them all out, we’ll certainly make those links available to you.
But on this video today, we are discussing how to choose the best or maybe more importantly, the right senior care community. So one of the, and this is a broad topic but we’ll try and pack the most information, the most valuable information that would be applicable maybe to you, into this video today.
So when you’re touring a senior care community, Steve, what are the questions that a person should ask? I know there’s a lot of them, but what are the main questions a person should ask when touring a senior care community?
What Questions Should One Ask When Touring A Senior Care Community
Well, it’s a really, really important question. When I work with our clients from Senior Care Consulting, we actually conduct a 97 point inspection and performance audit. Most people are not going to do that, or may not have the expertise to do that, but I’ll tell you, I have an audit tool here in my hands, and I was just going to go through a few of the things that I think everyone should ask about.
Check For Deficiencies
So, one thing to try to wrap your arms around and understand is, how did this place do on their most recent surprise health inspection? And what that is, is the state, any state you live in, they have their representatives from the state and they’ll do a surprise health inspection and they’ll come in and they really just tear the place apart. And they want to make sure that this community is following its own stated policies and procedures. And that they’re meeting local state and federal regulations. And if they’re not, then they’re written, what’s called a deficiency. And of course a fewer deficiencies would be better than a large number of deficiencies.
The lower the letter of the deficiencies, the lower the infraction. The higher the letter, the higher or the worst of the infraction. So that’s really important to know about and understand. And by the way, all of that information is freely available to the public, just do a Google search in your state, and you should be able to get your hands on that and see the most recent report. So that is really, really important.
How Many Administrators or Executive Directors
I would want to know, how many administrators or executive directors and then directors of nursing have been there in the last five years? Fewer is better, on that one.
What Are The Staffing Ratios
And then, what are the staffing ratios? I think most places don’t really know their staffing ratios. That’s one of the things that Senior Care Consulting does, is we determine the exact staffing ratio, but I would try to find out information like that.
And then, what kind of training do they offer their staff, can provide for their staff? And then this one is a big question to me personally, it may not be as important to everyone, but everyone has to do a criminal background check, license and registry check. They do TB testing and references, et cetera.
But here’s the key question, at least in my opinion, do you drug test new hires? Do you do any ongoing drug testing of the staff? Now, believe it or not, many states do not have this as a requirement. I personally think it should be a requirement, and believe it or not, a lot of communities do not drug test their staff, their new hires, and then they don’t do the random ongoing testing. They’ll only drug test for cause. So to me, that’s kind of a big deal, maybe it’s not to you.
How Many Resident Falls Does The Community Average
How many resident falls do you average in a typical month? And they will know these numbers or they should know these numbers. If they don’t know, they will be able to get these numbers for you.
And then ask about the medical director, who are they, what’s their specialty, how often are they or a representative from their group in the building, seeing residents? What are some of the other medical specialists that come into the building to help out and to check on the residents? So podiatry, optometrist, audiologists, et cetera, et cetera. And then what pharmacy do you use? And then, can I use a different pharmacy if I prefer?
Get A Clear Idea of Costs
And then ask about any additional, add on fees over and above what you’ve been quoted.
Okay. So find out the exact cost and then, do I pay extra for laundry? Do I pay extra for cable or for phone or for internet use? And just all these other things, ask about any additional costs that you may incur. And then do you use temporary staffing agency for your staffing?
What Is The Average Call Light Response Time
Let me just hit one more, I was just looking at my audit tool. What is your average call light response time? It needs to be less than five minutes. Some of the best places in Kansas City are somewhere between two and four minutes, and that’s actually monitored and provable. Sometimes if they say, it could take 10 or 15 minutes, it’s just too long. So in my opinion, okay? So, those are a few of the questions that I would definitely ask. Again, our clients, we provide a 97 point inspection and performance audit, but if you’re out doing this on your own, those are some of the things that I would definitely check out.
Okay. And yes, the 97 points to me obviously sounded like very thorough, very intensive, so that the one of your clients certainly knows what they’re going to get, I would think going through that that audit. And thank you for touching on the most important ones there. Along with that, I guess, are there any specific or otherwise important factors to consider when making the final evaluation to see if that is the right senior care community to move to?
Additional Factors To Find The Right Senior Care Community
You bet. You bet. There are many factors, I just want to touch on two, that are just super important in my opinion. Ask the question, “What happens if we should outlive our assets?” So you’ve done a calculation and you have your cost and then you have the person’s income. And then the difference between the cost and the income is your burn rate that you would divide out into your assets.
So, if you say, we can pay privately for 10 months, or two years, or four years or whatever the number is, give an estimate of when you think you will run out of assets and no longer be able to pay privately for your care. And then at that point, and your loved one’s still living there, what happens when we run out of assets or outlive our assets? And you have to understand that a lot of places are Medicaid certified, meaning at that point, you should be able to qualify for Medicaid and have Medicaid pay the majority of your costs moving forward.
But guess what? A lot of places are private pay only. And at that point, you’re going to be discharged. You will be asked to leave and all of a sudden you’ve been there, one or two or five years, you’re three, $400,000 into your stay. You’re out of money, and now you have to move again. Most people don’t want to do that.
And then the other major factor, and this one comes back to haunt so many people just like the first one. Do you offer memory care? Now, guess what they’re going to say? Every single place will say, “Oh yeah, we care for residents with memory issues, memory impairment.” Well, that’s not the right answer. And they do, all places do that.
But what happens if your loved one, even if it’s really early on in the stages of Dementia or Alzheimer’s, that progresses, that advances, the person’s cognitive abilities decline. What happens if my loved one hits a certain point to where they’re a wandering risks, they’re are flight risk, okay? Elopement Risk is what the industry calls that. What happens if they’re exit seeking, what happens if we have behaviors and there’s agitation? What happens if we’re wandering in and out of other residents rooms and that’s very disruptive and you can’t do that? Do you have a Memory Care Unit, Memory Care Neighborhood, a dedicated space in the building to care for cognitively impaired residents? So, it’s a small space in the building that that can care for maybe 20 to 30 residents, it’s a smaller part of the building. There are codes on the doors and all the things that go along with memory care. If they don’t have that for your loved one to transition into, guess what, you’re going to be asked to move, and you’re going to be discharged from there. And now you’re starting to search all over again.
So if memory issues are a concern, make sure that they have a dedicated memory care unit or neighborhood. And then ask the question, “What happens if we outlive our assets?” Those are two major factors to definitely cover.
Very good. Steve, thank you again for the information. I know that all that’s going to be incredibly important if people are searching for the right senior care community to get into. And certainly encourage anybody to watch the entire series that we’re recording here. And also importantly, how, if a person wants more information, if they would like to chat with you about that audits and maybe have a reason to have you help them with that audit, what’s the best way to find you or how to contact you?
Sure. Our phone number is (913) 945-2800. So (913) 945-2800. You can also visit online at SeniorCareConsulting.com. And Ben, since we had the year of COVID, I’ve done everything virtually, and so that has given me the unique ability to work outside of the Kansas City or extended Kansas City geographic area. I’ve helped people in Seattle, Washington, Norfolk, Virginia, and St. Louis, Missouri, just all over the place. So if you don’t live in Kansas City and you think you need this help and it would benefit you, we can definitely talk about providing this placement service through Senior Care Consulting, regardless of where you live, anywhere you live in the country, we can help.
Very good. And of course, we will put your contact information and links to your website where people will see this video as well. So Steve, thank you again for all the information today, and thank you for being here.
You bet. Thank you very much.
And have a great day. Thank you.
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