As the population ages, the need for long-term care becomes more prominent. Caring for a loved one who is elderly or physically or mentally ill is a big responsibility. A long-term care facility might be a solution, providing a safe living space and round-the-clock care.

Learning the process can help ease planning. Steve Kelley, adjunct faculty in long-term care administration at the San Jacinto College Central Campus, shares his insight.

Long-term care imageQ: What are some key resources for getting started?

A: Start with Health and Human Services Commission, Department of Aging and Disability Services, and licensed administrators working in the field.

Q: What are some tips for searching and selecting the best place?

A: Research and look at reviews. Keep in mind, no facility is perfect. Meet with key leaders in the facility to answer questions and resolve concerns.

Q: After selecting a facility, what is the next step?

A: I ask prospective residents/family members to do three things:

  • Tour the facility during business hours and weekends.
  • Review ratings at
  • While in the facility, look, listen, and smell.

Q: Trust is important when placing a loved one in a long-term care facility. What are ways to build trust and ease concerns?

A: News stories paint the worst-case scenarios of nursing facilities, but most facilities truly attempt to be the best possible home for their residents. Be accessible and communicate often with the staff.

The facility should make sure the resident’s physical, social, and psychosocial needs are being met. The entire staff should make the resident, family members, and guests feel welcome.

Q: Is long-term care costly, and does insurance help? 

A: For residents to live in a nursing facility, room and board can be anywhere from $200 to $300 per day or $6,000-$7,000 per month. Most residents, namely seniors, rely upon Medicare (A and B) for hospitalization and rehab services in a skilled nursing center. Medicaid provides funds for most, if not all, costs for long-term care living.

Social Security income or retirement funds represent the applied income the resident contributes for their care. There are individuals who are full vendors, meaning they do not have or are not required to provide any financial support for their care. Medicare Advantage/managed plans (Medicare C) are plans such as United Health Care, Humana, Cigna, etc., that may act similar to Medicare. The insurance company will require the facility to provide clinical updates to retain the resident on services. There are also Medicare Drug Coverage (Medicare D) and private pay.

Q: How involved should family or caregivers be to ensure top care?

A: Involvement has no limit other than no family is allowed to stay overnight with a resident. They should come often. They should be engaged in their loved one’s care and should get to know the leadership and staff, primarily the administrator and director of nursing. Work with the leadership in any nursing home to ensure the resident is getting the best care. 

Q: How much can a resident bring when moving in?

A: Most residents will share a room. Room sizes vary, but they are not large. Minimum requirement for private room is 100 square feet (10×10 bedroom in a home). Minimum requirement for a semi-private space is 80 square feet per resident or 160 total square feet. Closets are small.

Tours will allow the family to get a feel of the downsizing needed before the move-in date. We occasionally have hoarders, which can become a safety issue with such limited space.

Q: What else should people know about admission and acceptance?

A: It is a two-way street. A facility will look to admit residents for whom they are equipped to serve the needs, are good community citizens, and have a source of payment. Facilities aim to provide a nice, comfortable, home-like environment.

Potential residents must understand what is happening. Not every facility can handle all aspects of care for residents such as those who need breathing tubes, ventilators, wound care, and IVs. Facilities may be noisy at times because of the number of residents on the hall or in the facility.

Q: What should the resident/family member expect?

A: Transparent and honest communication. Access to leadership, especially the administrator and director of nursing. Returning of calls when seeking information, which may take a day if the call was made at night. Visitation hours might be different in each facility. Family and visitors must follow the facility’s COVID and other safety protocols. 

Lastly, give the facility an opportunity to correct any grievances. Too often, people complain to the state when issues can and should be resolved in house. Try to be pleasant even in difficult situations.

Learn more about San Jac’s long-term care administration program at

  By Neesha Hosein