I would like to the legal requirements for starting a long term care
or nursing home in Creek County, Oklahoma.  This would include any
city, state, and federal requirements for a small residential facility
of approximatly 10-20 beds.  The focus would be on patients that are
bed ridden, generally seniors.  Thanks for your help!!

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Clarification of Question by jkm1317-ga on 27 Oct 2005 08:18 PDT

Yes, I know that was me as well.  Did you see the final comment by
another researcher?  THey said the question was to complicated for one
person to answer, so I split up the question.

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Clarification of Question by jkm1317-ga on 03 Nov 2005 21:45 PST

i found some more money to put up...please let me know if you need
further direction.

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Request for Question Clarification by pafalafa-ga on 18 Nov 2005 19:59 PST

jkm1317-ga,

I'm not sure anyone here can really give you a thorough overview of
the requirements for something as complex as starting up a nursing
home.

However, there are several groups that work specifically with small,
start-up businesses to assist them in negotiating the legal and
financial hurdles involved.


One of these is SCORE -- the SERVICE CORPS OF RETIRED EXECUTIVES. 
They will try to hook you up with a retired executive with relevant
experience.  There is no charge for the service.  Here are the
contacts in OK:


http://www.sba.gov/gopher/Local-Information/Service-Corps-Of-Retired-Executives/scook.txt



The Oklahoma Small Business Development Center offers similar services:


http://www.nwosu.edu/osbdc/



I would suggest reaching out to both these agencies, as their
assistance can be invaluable.


Let me know how that works out.


pafalafa-ga

See prior related question.

http://answers.google.com/answers/threadview?id=581549

Dear Sir- I am involved with nursing homes in my work so I will do my
best to answer you question (becuase if you knew what they pay nursing
home administrators these days you'd look for extra cash too!)

If it will resemble a nursing home (even if it doesn't these
regulations are the most stringent so you would be in FULL compliance
to abide by them" you would want to read these -

http://www.health.state.ok.us/PROGRAM/condiv/675act.pdf 

Also Centers for Medicare and Medicaid Services at 

http://www.cms.hhs.gov/default.asp? 

would be helpful.  

If you are going to renovate your existing structure there are Fire
Marshall Life Safety Codes specific for long term care facilities that
must also be met.  You can acquire the Life Safety Code for LTC
facilities at your local college library (just take a roll of quarters
for the copies).  You will also have to submit a plan, architectual
documents, etc. to your states Dept. of Health and Environment or
Dept. on Aging for approval.

PLease make note that there are Federal Regulations and State
regulations that must be met to maintain full compliance of your
facility.  You may want to visit the Oklahoma Association of Homes and
Services for the Aging at

http://www.okahsa.org/

This association represents all the nonprofit nursings homes in your
state.  I am assuming that your home will be nonprofit because of its
size and benevolent makeup.  They will be able to provide a tremendous
amount of information on where to go and who to talk to (lots of
resources).

You could also go here

http://www.medicare.gov/NHCompare/Home.asp?version=alternate&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home&CookiesEnabledStatus=True

and look up nursing homes in your area to compare.  You are able to
look at a history of deficient practices, staffing ratios, etc. etc. 
This might be useful to locate those providers who really excel at
what they do and then contact them for a tour or to ask questions.

Also you will have to go to 

http://www.nabweb.org/Home/default.aspx 

To operate a long term care facility it would be pertinent to become a
nusing home administrator.  At this site you can gather information on
how to do that (who to contact, reister to take the exam, request and
pay for a hard copy of the regulations, etc.)


Now, will all that said I'd like to speak candidly.  Please understand
that health care (namely long term care) is the second most regulated
field in the US next to nuclear power. It is this way because many
people have made many mistakes and many people have died, not
naturally, but from neglect and just plain bad care. In response the
federal government has taken the approach that even "risks or the
potential for harm" are not acceptable in nursing homes. There are
going to by multiple hoops for you to jump through for you to get your
endeavor off the ground.  Please also know that just becuase you feel
compelled to be a care provider for "the elderly" doesn't mean you can
just renovate your home (like a segment on Oprah) and change the
world.  The road to (you know where) is paved with good intentions.
Nursing home administrators go to jail when they are found to have
been providing consistently poor care. I don't mean to be discouraging
I just want to be honest and tell the truth.

Dear Sir,
I'm not familiar with your state, but I do operate an assisted living
facility in Georgia. Your first step is to determine if you want a
residential care facility or a nursing home. Each has different
licensing requirements. The residential care facilities in some states
have different levels of care, so you might start with this type
first. If no levels of care are in place, you can probably get waivers
for the bed patients. Each State has different names for residential
care facilities. Find out the official term first!

My advice is to contact your state licensing agency. If you don't know
who it is, call one of the other facilities in your area to find out
who is in charge of state licensing. Call this agency to request a
Rules and Regulations booklet. This should give you all the State
requirements. Read thoroughly. If you are confused, ask a State
Regulator to clarify.

Another important step is to check the zoning regulations in your area
to see if your location is zoned for this type of facility. If not,
you will need to re-zone or find a location that is already in the
correct zoning. Normally these are located in Office-Institutional or
Commercial zoning areas. If neighbors protest, forget it and find
another location.

The main thing is to read that Rules booklet to see if you can comply
with everything required. This would involve square footage of
bedrooms, number of bathrooms, handicap accessable requirements, menu
approvals, background checks on the administrator and all employees,
obtaining your admission forms, policy manuals, etc. You will need
approval from the City, the County, the Fire Marshall, Health
Department, State Regulators, and your neighbors.

Yes, there is a lot of paperwork and lots to consider....but well
worth the effort! I have had my facility for over 22 years and care
for approximately 32 residents. My son is now involved with the
operation, and my own parents live on the property.

In my situation, we are very careful to do as the State and Health
Department asks...because they are the ones who determine if we stay
in business. If you need more information, I can assist some, but
don't know all the answers. It takes a lot of investigating on your
part to comply with all the agencies and requirements.

Good luck, 
MsAzalea
www.azalea-manor.com