I Need Help Finding a Care Facility

Find Your Situation

• What kind of place do they need?
• Nobody has accepted them yet
• There’s no bed available
• How will it be paid for?
• A facility said no
• Behavior is blocking placement
• A medication or treatment is blocking placement
• They’re on hospice

Name the Care, Not the Building

Ask the current care team:

“What level of care does this person need now, and what specific needs must the next place be able to manage?”

Name the needs that may make placement harder:

• two-person transfers
• wandering or exit-seeking
• aggression, threatening behavior, or other behavior needing close supervision
• oxygen, wound care, dialysis, infusions, or other treatments
• medications or symptom-management treatments a facility may not provide
• feeding or swallowing needs
• hospice care

Include the person in the conversation whenever possible.

Know the Common Settings

Names and requirements vary by state and facility, but these are the common settings you may hear about.

Assisted living generally provides housing, meals, supervision, and help with daily activities. Nursing and hands-on care vary widely.

Memory care is designed for people with dementia or significant cognitive changes and usually provides a more structured or secured environment.

Skilled nursing or rehabilitation provides nursing or therapy for people who need skilled care, often after an illness, injury, or hospitalization. It’s often short-term.

Long-term nursing-home care provides ongoing nursing and personal care.

If the person is a Veteran, see I Need Help Planning VA Care Before a Crisis → for VA long-term-care options and help with costs.

The same building may provide more than one kind of care. Ask what level of care the person is being accepted for.

Find Out Who’s Actually Looking

Start with the hospital, hospice, clinic, social worker, or case manager already involved.

Ask:

• Which facilities received the referral?
• Which have reviewed the person?
• Which said no, and why?
• Has anyone actually accepted?
• Who’s responsible for the next step?

If the person is leaving a hospital, also ask whether an appropriate bed is available, whether payment is approved or pending, and when admission can happen.

“I understand the discharge plan. I need to know how these care needs will safely be met if there isn’t yet an accepting facility.”

If the plan depends on family providing care they can’t safely provide, say that plainly.

Ask Whether the Facility Can Actually Manage the Care

Don’t ask only whether a facility has a room.

Tell them the person’s actual care needs, then ask:

“Can you safely manage all of these needs now?”

Then ask:

“What would make this person no longer appropriate for your facility?”

That second answer matters. A place that works today may not work if the person later needs more help, more supervision, or care the facility isn’t staffed or licensed to provide.

Before choosing, look at inspection results. Nursing homes are on Medicare Care Compare. For assisted living, ask the state licensing agency for recent inspection reports.

If No Appropriate Bed Is Available

This is its own problem, not just a delay.

“There’s still no accepting facility. What’s the safe plan while the search continues?”

Ask what’s causing the delay, whether the search can widen geographically, and who’s responsible for continuing it.

Being on a waiting list doesn’t solve tonight’s care problem.

Sometimes the available choice is farther away, more expensive, or less preferred than the family expected.

Find Out How It Will Be Paid For

Do this early.

“If this is the level of care the person needs, what pays for it now, and what happens if that coverage ends?”

Payment may come from private funds, Medicaid when the person qualifies, long-term-care insurance, some VA benefits, or limited coverage from other sources.

Before moving money or property to help someone qualify for Medicaid, get legal advice. Some gifts and transfers can delay eligibility. See I Need Legal Help →

To apply for Medicaid to help pay for long-term care, see I Need Help Applying for Medicaid Long-Term Care →

Don’t assume Medicare will pay because the person can’t safely live alone or needs help with bathing, dressing, toileting, eating, medications, or supervision. Medicare may pay for qualifying short-term skilled nursing or rehabilitation. It generally doesn’t pay for ongoing long-term custodial care.

Ask:

“What will this cost if Medicare stops paying, and what happens if we can’t afford private pay?”

Don’t build a long-term care plan around temporary Medicare coverage.

If the realistic options are unaffordable, say that directly:

“These are the places that can meet the care needs, but we can’t afford the private-pay cost. What’s the next workable option?”

Don’t let an unaffordable recommendation be treated as though the problem is solved.

If a facility is trying to make the person leave, see I Got a Nursing Home or Assisted Living Discharge Notice →

If a Facility Says No

Ask:

“Can you tell me the specific reason you can’t accept this person?”

Then:

“What type of setting is more likely to manage these needs?”

“If this barrier changes, would you reconsider?”

Facilities may decline because of care needs, behavior, medications or treatments, staffing, payment, licensing limits, or because the right bed isn’t available.

One facility saying no doesn’t mean every facility will. But repeated refusals are information.

“What level of care or type of program should we be looking for instead?”

If Behavior Is Blocking Placement

Don’t soften what’s been happening.

“The person has been hitting, threatening, or trying to hurt people. Which settings can manage this level of behavior?”

Ask what level of supervision is needed, whether a specialized dementia or behavioral program may be necessary, and what the safe plan is while the search continues.

Don’t hide aggressive or violent behavior to get the person accepted. A placement that can’t safely manage it may fail and put the person, other residents, or staff at risk.

If someone may be hurt now, see I Am Afraid of the Person I Am Caring For →

If a Medication or Treatment Is Blocking Placement

“Which medication or treatment is preventing admission, and why?”

Then:

“Is the issue the medication itself, how it’s given, the monitoring it requires, the cost, or something this facility can’t provide?”

If the medication treats a serious symptom, involve the clinician or hospice team managing it.

“This medication is making it harder to find a place. Is there another option, or do we need a facility that can manage it?”

Don’t stop or change a needed medication to make placement easier without involving the clinician managing it.

If the Person Is on Hospice

Ask whether hospice can continue in the proposed facility, what the facility and hospice will each provide, and who pays for room and board.

Hospice enrollment doesn’t by itself pay for long-term room and board in a facility.

Before You Stop

Know:

• what level of care is needed
• which facilities have actually reviewed the person
• why any facility has said no
• whether an appropriate bed exists
• what will pay for the care