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By Janice Martin, Owner of Senior Liaison of Central Florida
A family recently contacted me to help them find an assisted living community that would provide an appropriate placement for their loved one with significant care needs. They had been through one ordeal after another and felt they had been given promises that were not fulfilled. Only after moving into a community did they realize they’d been misled when a life threatening occurrence arose.
Sadly, this is not an uncommon situation. When an individual has a care need that has the potential to need a heightened degree of responsiveness due to their diagnosis, it is imperative that the questions that are asked during the initial visit are very specific. The perfect example is related to nursing availability. The question is often asked, “Do you have nurses 24/7?” While this appears to be precise, it is not. In this example, the evasive answer is generally yes. Yes, they have caregivers and nurses available 24/7. What is often not disclosed is that the nurse goes home at a certain hour and is then only available by phone. Should an urgent need arise in the middle of the night, the staff must call and wake the nurse and explain the situation. The nurse must then get dressed, drive to the community, park the car, and make their way to the resident before providing the care. This could easily take up to an hour or longer, which is not always practical.
Instead, the correct way to phrase it is, “Are there nurses IN THE BUILDING 24/7?” Very specific. What is surprising is there are very few communities that do. Some will tell you that they don’t because it’s difficult to find nurses. While this is true, there are staffing agencies that readily provide temporary nurses to assist until a permanent nurse is hired. Sadly, they may choose not to utilize this due to cost.
While assisting this family, I reached out to several communities to ask about their nursing standards. Although I knew a few that have nurses in the building overnight, I was shocked to learn that some that previously did no longer do. Because I didn’t specifically ask if the protocol had changed, they didn’t share that it had. Thankfully, I was able to locate one that does.
There are three levels of licenses in assisted living – Standard, Limited Nursing Services (LNS), and Extended Congregate Care (ECC). Each offers an increasing degree of authority to provide care.
Previous regulations governing assisted living communities had only allowed those with an LNS or ECC license to provide hands-on nursing care. How-
ever, a Standard license now allows nurses the authority to provide greater care. What is interesting is that although a community with an LNS or ECC may deny a potential resident due to their care needs, a community with a Standard license may choose to accept them. It will depend upon the community’s protocols and the availability of nurses in the building.
Such was the case while helping this family. I met with the Executive Director of a community with a Standard license who consulted with their Director of Nursing to determine if they could provide the care needed with 24 hour LPNs. I was assured by this trusted leader that they could help.
Despite my confidence, I felt it was necessary to reach out to the Agency for Health Care Administration (AHCA). AHCA is the governing agency that creates and enforces the regulations surrounding assisted living communities. I spoke with a representative and specifically asked if a community with a Standard license has the authority to provide the level of care needed in this situation. I was assured they could. I then asked if I could see it in writing for final confirmation and they obliged.
There are some key factors that are important to understand. Not all situations require this level of oversight. Critical needs that would make it necessary includes 1) someone who may have frequent falls where a nurse is available to assess the situation before automatically sending the resident to the hospital; 2) someone with a blood disease that causes heavy bleeding in need of frequent bandaging; 3) a diabetic who needs to have their glucose closely monitored and insulin administered; 4) a person with a port that is prone to infection; 5) or a colostomy bag that could leak. Not all licenses will allow for all of these circumstances so it’s important to disclose these needs during your search.
The story I shared is the perfect example of why a family should never walk into a community without representation when there is a life threatening health concern that must be managed diligently. It is important that the representative has a solid understanding of the communities in the area, understands their licenses, protocols, and staffing, and communicates full disclosure of the specific situation before referring the community to a family. There are national companies that are merely directories of community names that do not understand this. I encourage you to work with a LOCAL professional who will guide you one on one to achieve the outcome you and your family deserve.
Janice Martin is an author, educator, and specialist on senior living options and the owner of Senior Liaison of Central Florida Inc. She assists families in locating senior living communities and has written “The Complete Guide to Assisted Living: Everything You Need to Know Before, During, and After a Move.” This award winning and #1 best seller is available on Amazon.com in paperback and eBook. For more information, call 352-477-1866 or visit www.seniorliaisoncfl.com.
Senior Liaison of Central Florida
352-477-1866 | seniorliaisoncfl.com
seniorliaisoncfl@gmail.com
