What is the Choose Well Website and Facility Score?
The Choose Well website and facility scores help seniors, their families, care giving professionals, and others locate and find placement with assisted living providers who have distinguished themselves with both their track record for compliance and their participation in the Choose Well program. All facilities partnering with the County on this program have volunteered to be rated and to have their score displayed. Periodically the facility providers' scores are changed, using the Choose Well Scoring Device, based on when the state next visits the facility. Their participation and willingness to receive a Choose Well Score shows their commitment to the San Diego community.
Choose Well Elements
A Choose Well facility's score is a numerical value. The score is made up of a Public Records score and bonus points earned from Facility Provided Documents or from receiving a Substantial Compliance finding resulting from a required state inspection.
Public Records: A Public Records score is based on a facility's compliance with state regulations. Compliance with state regulations is put into context for families using the County's 11 Quality Measures. The Quality Measures spotlight what areas of compliance are important when operating an assisted living facility.
Citation information for the Public Records score comes from the state's records. Whenever a state inspector finds that a facility is not in compliance with a regulation, a citation is issued and recorded in a public document. The public record documents are the Facility Evaluation Report (LIC 809), the Complaint Report (LIC 9099), the Non-Compliance Conference Summary Report (LIC 9111), and Civil Penalty Assessments.
The Choose Well scoring tool evaluates a facility's compliance with 94 Title 22 regulations and Health and Safety Codes that are associated with the 11 Quality Measures. Citations in any given Quality Measure will lower a facility's Choose Well score. Every facility starts with 100 points. Families can see how many citations (Count) a facility has received from the state in each Quality Measure.
Recently licensed facilities volunteering for the Choose Well program who have not yet received a post-licensing state inspection will not have any public documents data to put into the scoring tool. These facilities are designated as Newly Licensed until they have had a state inspection.
Bonus Points: Choose Well offers providers two types of bonus points: Those earned by uploading five key documents described below, and two point points for each Substantial Compliance finding issued by the state following a state-required Inspection (Annual Random, 3-year, 5-year).
Five-Key Documents: Bonus points are given to those facilities that upload any of five key documents that relate to information consumers care about. A facility gets points added to its Public Records score for each of the five key documents it uploads. These documents are:
- Price List (2 points): The Price List is key for families. Families want to find a facility that gives the highest quality of care in the best place they can afford.
- Fall Mitigation Program (1 point): Because falls are a concern for every family, the facility's plan for how it minimizes fall risks, how it protects a resident against falls, and what its procedures are for caring for a resident who falls are very important to a family.
- An Infectious Disease Control Policy (1 point): This document lets families know that the facility takes contagious diseases seriously, and that it has procedures to protect other residents and staff from getting sick.
- License and Approval for Specialty Care (1/2 point): On these documents, families can see the permissions or approvals the state has given to the facility allowing them to provide care for hospice or bedridden residents, a locked perimeter for dementia care, or other types of special care needs.
- Dementia Plan of Operation (1/2 point): Many assisted living residents have dementia. Families want to know a facility's approach to caring for residents with dementia.
Substantial Compliance: A finding of "Substantial Compliance" is an outcome of a state-required inspection (Annual, Annual Random, 3-year Required, 5-year Required). The state inspector gives the "Substantial Compliance" finding if the inspector determines that the facility is complying with the state regulations for operation of a residential care facility for the elderly. To qualify for a Substantial Compliance outcome, the facility cannot receive any citations during a required inspection.
Facility Rescores: State inspectors visit facilities for many reasons: required inspections, case management visits, plan-of-corrections, and complaint investigations to mention a few. Each time the state visits a facility it is documented on either a LIC809 form (Facility Evaluation Report) or a LIC9099 (Complaint Investigation Report).
If the state finds the facility in violation of a regulation or the Health and Safety Code, the facility will be cited for that violation. When the Choose Well Project Team is notified of the state visit, the visit report is evaluated to see if the facility received a citation or a Substantial Compliance finding. In either case, the facility score is rerun, using the current and County-approved algorithm.
The facility is notified of the scoring change, and is given 10 days to accept the new score, appeal the new score, or opt out of the program. If the new score is accepted, the new score, and the related Quality Measure Counts will post to the website, becoming public. In this way, the website is dynamic, and is reflecting the current performance of the Choose Well providers.
Choose Well as an Indicator: A Choose Well Facility Score cannot measure all aspects of resident care. The Choose Well Score is just one indicator of many that you will want to consider as you decide which assisted living facility is best for you or your loved one. The Choose Well program recommends you use several methods for learning about the facilities you are considering. For instance, take a tour, eat a meal at the facility, or visit the Administrator to discuss your family member's needs. You can also ask the facility Administrator for references so that you can talk to other families who have placed a family member in the facility.
Other considerations that may help with your decision may include:
- How much is the monthly rent?
- Is the facility close to you so you can visit often?
- Is the facility clean?
- Does it have offensive odors?
- Does the facility provide the type of care your family member needs?