THE ATTORNEY GENERAL OF TEXAS
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The Attorney General Talks About Choosing Long-Term Care

The Attorney General Talks About Choosing Long-Term Care By Greg Abbott Attorney General of Texas Making arrangements for long-term care, whether for ourselves or for loved ones, can be difficult. Choose carefully: making the right selection now can help ensure comfort and security for years to come. The Texas Department of Human Services (DHS) licenses long-term care facilities and categorizes them into five groups. These are nursing facilities, intermediate care facilities for persons with mental retardation and related conditions, assisted living facilities, adult daycare facilities, and Home and Community Support Services Agencies (HCSSAs). A nursing facility, commonly referred to as a nursing home, is a healthcare facility that provides organized, structured care 24 hours a day. Nursing homes are generally for those who need constant medical attention. All basic medical and personal necessities are provided by the staff. Assisted living facilities provide individualized health and personal care assistance in a home-like setting. These facilities emphasize autonomy and privacy while still maintaining general oversight. Adult daycare facilities provide health, social and related support services for adults in a structured environment. Health care services may include nursing, personal care and therapy services. Participants do not stay overnight. HCSSAs include home health agencies, hospices and personal assistance services. They provide medical services and routine, ongoing care such as feeding, preparing meals, bathing, dressing, grooming, transferring, and walking. Once you determine the type of long-term care most beneficial to your situation, research the facilities or services in your area. If you are looking for a residential facility, it may be helpful to use a facility that is near your family or friends. However, you should select several facilities to compare. Some are much better than others. Ask a trusted physician for recommendations, or talk to family and friends about their experiences. Once you narrow your choices, visit the facilities in person to evaluate the environment. Simple observations such as smell and appearance should be taken into account. Take some time to talk to staff and residents. The State of Texas inspects nursing facilities once a year. Ask for the most recent survey report, which the facility is required to post. Most facilities have some violations, but this does not necessarily mean they provide poor care. Strict standards exist for items such as nursing care, quality of life, dietary services, and safety concerns. You should review the report closely for infractions in these areas. Ask questions such as: What is the ratio of nurses and nurse's aides to patients? How many complaints have been made against your facility? What kind of turnover do you have for nurses and nurse's aids? Ask to see the facility's policy for emergency care and any other areas that apply specifically to your or your loved one's medical condition. DHS also inspects HCSSAs on a periodic basis, and the inspection results are required to be made available when requested under the Public Information Act. You can ask service providers questions such as: Does the agency provide services in your part of town? Does the agency have substitute staff when the regular staff is out? What are the normal hours of operation and what services are available after hours and on holidays? What are the policies regarding emergencies? You should also inquire into billing practices and whether they accept Medicare and Medicaid. The majority of long-term care providers are caring individuals who provide excellent service to their clients. By knowing what to look for, families can make sure that their loved ones receive the best care possible. POINTS TO REMEMBER SELECTING LONG TERM CARE For information about long-term care providers or to file a complaint about a long-term care facility: Department of Human Services (800) 458-9858 www.dhs.state.tx.us For more information on senior issues: Office of the Attorney General (800) 252-8011 www.oag.state.tx.us To report abuse or neglect of a resident in a Medicaid-funded facility: Medicaid Fraud Control Unit Office of the Attorney General Telephone: (512) 463-2011 Fax: (512) 320-0974 E-mail: mfcu@oag.state.tx.us For Nursing Home Ombudsman assistance and benefits counseling: Texas Department of Aging Area Agencies on Aging (800) 252-9240 www.tdoa.state.tx.us Information on this and other topics is available on the Attorney General's Web site at www.oag.state.tx.us.