Choosing a Care Facility

Initial placement
Publicly funded placements to residential care facilities in British Columbia are governed and administered by the regional health authorities. Typically, placement is from one of three sources: an acute care hospital, through a transfer from another residential care facility, or directly from home.

The key individuals involved with placement are usually the case manager assigned by the regional health authority, the social worker or discharge nurse at a hospital, or the social worker of a residential care facility.

Initial placement to a residential care facility may not involve choice, but will likely be to the “first available, appropriate bed,” in consultation with a case manager or social worker. This is in keeping with the needs-based Residential Care Access Policy administered by the Ministry of Health Services, in which access is determined based on a client’s care needs and urgency.

Under this policy, there is often little notice when a bed becomes available. Families may find they need to make a decision quickly, and move their loved one into care within a very short period of time. While this can be traumatic, the intent of the policy is to ensure that those who are most in need of a care bed get one first. After initial placement into care, it is possible to request a move to a different facility based on resident or family preference, or based on the needs of the resident.
Please see the information prepared by the Ministry of Health Services, “B.C.’s Residential Care Access Policy”, for more details. (requires Adobe Acrobat Reader)




Facility choice
In some geographical areas of British Columbia there are few residential care facilities, and as such, choice of facility can be limited. In other geographical areas there is more choice, although at the ‘complex’ or ‘extended care’ level, the choices can still be fairly limited. Many private facilities do not provide care for residents at the complex or extended care level. Facility choice will be influenced by the location where the potential resident lives, or would like to be placed, and on the level of care they require.

Placement in an area in British Columbia, other than the one where the potential resident resides, is possible. This can be discussed with the case manager, discharge nurse or social worker handling your case.


Helpful resources for choosing a care facility
The Ministry of Health Services has prepared a helpful document, which provides practical advice, tips and questions for consideration to help family members and potential residents evaluate licensed residential care facilities. Download “Choosing a Care Facility or Home” (requires Adobe Acrobat Reader)

Some regional health authorities publish a list of publicly funded care facilities in their region, which includes specific information on each facility. Check with your case manager, or contact your regional health authority to enquire about information available on residential care facilities in your area.


What to look for in choosing a care facility
Choice of a care facility is very individual. Facilities that are well matched for some residents and their families may not be the right choice for others.

A critical consideration is the fit between the needs of the potential resident and the ability of the facility to meet those needs, particularly in relation to the levels of care provided. Thoughts for consideration include:

• The functioning level of potential residents varies significantly and will typically change over time

• Needs that can be met by a facility during the earlier stages of a disease or medical condition may not be as well met in the middle or later stages, or vice versa

• A frank discussion with your case manager from the regional health authority, or with the social worker at the facility about the current and foreseen functioning level of a potential resident can provide helpful information on the choice of a facility

• Important issues to address might include: feeding; suitable activities and access to them over the course of disease progression; and the availability of specialized items, such as pressure-reducing mattresses

Other factors to consider in choosing a facility include:

• Availability of and accessibility to rehabilitation services and activity programs, such as occupational therapy, physiotherapy, walking programs, and music therapy, that are appropriate to a range of functioning levels

• Proximity to family and friends

• Availability of private rooms

• Staff that speak a specific language

• Availability of ethnic foods

• Availability of foods that cater to specific dietary requirements

• Access to a primary care physician
For some residents and families, continued access to a family physician can be a deciding factor in the choice of a facility; for others this is not an issue.

• Access to specialists and specialized medical care
For example, some facilities are authorized to provide higher levels of care – such as ventilator therapy, the use of feeding tubes, or intravenous therapy (IV therapy) – with their own nursing staff, or with the assistance of a community health nurse. In cases where the facility is not authorized to provide specialized care, a resident in need of specific treatments will usually be transferred to a hospital for the duration of the therapy, or on a daily basis.

• The presence of a resident or family council at the facility
Copies of the minutes from resident or family council meetings may be available and can provide additional insight into any current or recurring issues, as well as the facility’s response to dealing with them.