• become more aware of the different types of care available
  
• learn some of the best ways to search for the answers to care levels and facility types
  
• locate professionals equipped to help in the search and placement processes
  
• learn about residents' and patients' rights as set forth by the Commonwealth and other concerned health-related organizations
  
• learn how to work through some of the challenges faced in making a decision involving long-term care and
  
• learn some of the industry terms to enhance a clear understanding of all options.
  

Long-term care services and facilities comprise a growing segment of the health care industry that includes a network of professionals and facilities offering home care and personal services, a wide array of community services and many levels of residential assisted living and health care.

To help us understand the differences in home care services and the various forms of residential care, the guide is presented in three major sections beginning with a discussion about choosing a long-term care path. Then we take a close look at home care options and finally we learn about the options that provide us with a home and built-in services--residential long-term care services.

The five types of licensed care services and facilities covered are:

• HOME CARE and COMMUNITY BASED CARE
  
• ADULT DAY CARE
  
• CONTINUING CARE RETIREMENT COMMUNITIES
  
• ASSISTED LIVING FACILITIES
  
• NURSING HOMES
  

To provide the best service and appropriate level of care to the individual resident as well as prepare programs that contribute positively to the overall well-being of an assisted living facility's population, it is important for each facility to have a thorough understanding of each resident's physical and emotional needs. Therefore, as with other long-term care services and facilities, assisted living facilites require that an assessment be conducted prior to admission as part of the admission process. The assessment is reviewed and a reassessment is performed at least once a year and whenever there is a significant change in the resident's condition.

Homes that accept non-ambulatory residents are required to meet special building code requirements. Depending on a facility's compliance levels under the Uniform Statewide Building Code, assisted living facility residents may be:

• ambulatory--in response to an emergency physically and mentally capable of exiting the facility without assistance
  
• non-ambulatory--unable to exit the facility in an emergency without the assistance of another person.
  

When a resident is admitted from an institution for people with developmental disabilities or mental illnesses, an agreement between the assisted living facility and the local community services board, a state mental health clinic or a private facility or physician for the provision of appropriate services is required.

STAFFING

In a small assisted living facility, staff members may do double duty, filling several roles depending on need; in large complexes, staffing may be quite extensive. Regardless of size, five critical areas must be adequately staffed to meet state requirements:

• administrators who are responsible for the management of the home
  
• aides and companions who assist the residents with daily activities
  
• maintenance and housekeeping staff
  
• food service personnel and
  
• activities planners and facilitators.
  

RIGHTS AND RESPONSIBILITIES OF RESIDENTS

We encourage you to review the Rights and Responsibilities document for assisted living facilities. It is part of the Code of Virginia. Facilities must make a copy available in an easily accessible place for review. The facility must also make its policies and procedures for implementing the Rights and Responsibilities available and accessible to the general public as well as residents, relatives and agencies. Read about your rights and responsibilities in this guide, then compare it to the assisted living facility's version.

A FAST-GROWING, POPULAR OPTION

Affordability, coupled with the congenial, settled residential character of the facilities have boosted the popularity of assisted living facilities. Assisted living facilities offer a less-restrictive environment for individuals who need some assistance but do not need the level of care offered by a nursing facility.

NURSING FACILITIES AND SKILLED NURSING FACILITIES

With their 100-year-old history, nursing homes, now called nursing facilities and skilled nursing facilities, are one of the most recognized long-term care providers.