This is the seventh in a series of articles intended to demystify the experience of living in a retirement community.

This article focuses on nursing/skilled nursing facilities that provide long-term care in two retirement communities in the Prescott, Arizona area, Good Samaritan and Las Fuentes. (The other two communities visited for this series, Alta Vista and Granite Gate, do not offer these units.)

One remarkable fact about these facilities, compared to others with which I am familiar, is how quiet they are.

Every facility has patient alarm systems. Some alarms are triggered when residents press a call button. Others are triggered when people with some cognitive limitations try to do something that is unsafe for them. For example, if it is unsafe for someone to get out of bed unaided, his bed may be fitted with a pressure pad that sends an alarm if he is no longer lying down.

In many facilities, it is not unusual to hear alarms go off every few minutes. At the sites I visited, I did not hear any.

Residents generally seemed to be quietly occupied, either in their rooms or in group activities. Pet therapy dogs are common sights in the long-term care units. Most residents eat in the dining rooms.

Good Samaritan provides unusual training to new administrators of its nursing/skilled nursing facilities. They are picked up by a van at home, transported in a wheelchair, taken to live in the nursing/skilled nursing facility for two or three days, and treated like every other resident. They develop a profound understanding of what it is like to have to depend on others.

At Good Samaritan, volunteers routinely play the piano for residents at lunch. Unexpected upgrades, such as leather couches in various nooks, are common. These were often bought with money donated to this nonprofit organization for that purpose by families who appreciate the care given to their relatives.

You might be surprised at how engaged long-term care residents are. Good Samaritan staff helps them with email, Internet access and Skyping their families. An activities staff offers many outings, including ones to events at Tim's Toyota Center.

Good Samaritan is working to upgrade its facilities in several ways. Vacated rooms in Prescott Valley are renovated with wood flooring, dark wood armoires and flat-screen TVs. A new Electronic Medical Records system, or EMR, is expected to be up and running by March 2013. EMRs promise increased efficiency, safety and accuracy in tracking patient status, care and needs.

Las Fuentes offers the largest nursing/skilled nursing unit (128 beds). Its size allows it to have a doctor onsite four days a week -- an unusual and reassuring feature.

It has a beauty salon right in the unit, and a dedicated ice cream parlor where free ice cream socials are hosted three days a week. It allows smoking (on an outside patio, under supervision.) It offers a wide variety of activities, including games such as Bingo and blackjack. Free manicures are offered weekly.

The Las Fuentes physical plant has some limitations. The only central gathering place is a windowless dining room. Some residents were observed simply sitting in wheelchairs in the hallways. Furniture and carpeting in some rooms I glanced into seemed quite a bit worse for the wear.

That said, the Las Fuentes staff showed a genuine, heartfelt commitment to their residents, and showed creativity in meeting their needs.

If a facility happens to have only one bed available and is faced with two potential residents who have equal needs for care, one of whom resides in their affiliated independent living or assisted living units and one of whom doesn't, they are likely to give priority to the one who already lives in their retirement community.

In practice, though, typically about half the residents in nursing/skilled nursing at both Las Fuentes and Good Samaritan have come from outside the retirement community itself; they had been living in their own houses or in apartments not affiliated with the facility. They may even have been living in a different retirement community.

Said another way, assuming that space is available, nothing stops assisted living residents at Alta Vista or Granite Gate from moving to Good Samaritan or Las Fuentes if they need long-term care.

-- Next -- 088. Memory Care Facilities in Retirement Communities