How to Choose the Right Assisted Living Facility: Key Questions to Ask During Your Tour

From location to budget and lifestyle, there are many factors to consider when choosing an assisted living facility. Plan to tour more than one community: chances are, the first one you visit won’t meet all your loved one’s needs. Even if it does seem like a good fit, its worth exploring others. The more facilities you tour, the more well-informed your choice will be.

Around half of all families A Place for Mom has helped were referred to between four and six communities.^[01] (We refer families to partner communities that would be a good fit for their loved ones.)

Rachel Levy has helped many families through the touring process. Before joining A Place for Mom, she gained 20 years of experience in management roles and as a sales director in senior living communities. To keep the communities clear in your mind, Levy recommends spacing out tours.

To prepare for your visits, discuss these topics to determine what matters most to you and your loved one:

• Price
• Floor plans
• Amenities and services
• Programming and activities
• Levels of care
• Caregiver training
• Staff friendliness
• Staff-to-resident ratio
• Community culture

Costs and fees

Affordability is one of the most important factors in choosing an assisted living facility. To understand all fees, ask directly about monthly costs, charges for any add-on services, and financing options. Levy encourages families not to shy away from financial questions, as these can affect your loved one now and in the future.

“Rents typically increase at a senior living community just like they do at apartment buildings. Don’t be afraid to ask about that,” she says.

Important cost- and finance-related questions include the following:

• Is a contractual agreement available that lists all health care and supportive service fees, as well as admission and discharge fees?
• What are the policies for refunds and transfers?
• What are the billing and payment policies?
• Are all services included in the monthly fee, or are some services considered optional, such as housekeeping, medication management, transportation, etc.?
• Are hygiene supplies, such as incontinence products, included in the monthly price? If not, what’s the cost for these items?
• Does rent increase on a yearly basis, or is there a rent-lock program?
• Are there any pricing incentives or move-in specials available?
• Does the community coordinate with any public programs that may help cover the cost of care services, such as Medicaid, veterans benefits, etc.?
• Are residents required to have renters insurance? If so, what must be included in the policy?

Environmental safety

It’s important to learn how a facility maintains cleanliness, stays up to date on regulations, and ensures safety standards are always met. Answers to the following questions should help you understand specifically how facilities foster a safe environment:

• Does the facility undergo regular inspections? If so, ask to see the most recent inspection report.
• What safety and accessibility features (e.g., elevators, widened doors, stair lifts, wheelchair ramps, grab bars, and zero-threshold showers) are located throughout the community?
• Are all exits clearly marked?
• How often are the common areas cleaned and the grounds maintained?

Is assisted living the right fit?

Caregivers and staff

An inside look at how caregivers are hired, trained, and assigned to residents can help you assess how personalized the care is and how caregivers foster nurturing relationships. Ask these questions to get an idea of the facility’s caregivers and other staff:

• Do staff members make residents and visitors feel welcome? Do they call residents by their names?
• What is the caregiver-to-resident ratio? How many residents live there?
• How many caregivers and staff members are on duty overnight versus during the day?
• What kind of experience and training does the staff have?
• How does the community ensure a good match between caregivers and residents?
• Does the community perform background checks on every employee?
• What is the staff turnover rate? How long has each staff member been providing care in this setting?
• Does the community have a registered nurse, licensed vocational or licensed practical nurse, or certified nursing assistant on staff 24/7?
• Are caregivers able to meet the scheduled and unscheduled needs of residents?
• Can residents contact an on-site or on-call doctor, nurse, or other licensed health care professional during emergencies?
• Do caregivers assist with activities of daily living (ADLs)?

Health care services

If your loved one has been diagnosed with a complex health condition, it’s crucial to ask prospective facilities about the health care and transportation services they provide. Levy encourages families to ask as many questions as they want about care in the community and to be forthcoming with their loved one’s needs.

“Don’t feel like you need to hold back details,” she says. “It’s really important to be honest since communities are not alike. It will only help a community to determine if your family member is a good fit.”

Health care questions to ask include:

• Are physical and health assessments performed on residents prior to admission?
• Does each resident have a written plan of care? If so, how often is it updated?
• Does the facility’s care assessment include the resident, their family, the facility staff, and the resident’s doctors?
• Is there a process for a resident to appeal a care decision that affects them?
• Is the facility licensed to administer medications?
• What’s the medication management policy? Is self-administration of medication allowed?
• Are there any additional care services or therapies available on-site to accommodate changing needs (e.g., hospice care, dementia care, and physical therapy)?
• Are caregivers or on-site health care professionals equipped to provide care for residents diagnosed with different medical conditions (e.g., diabetes, chronic arthritis, and kidney disease)?
• Who coordinates home health visits from nurses, doctors, physical therapists, and other providers if needed?
• Is there a clear procedure for responding to medical emergencies?
• Are transportation services available to residents for doctor appointments? If so, do staff coordinate transportation? Is it wheelchair-friendly? Are mobility escorts available?
• Are there health conditions or levels of acuity that the community isn’t able to manage or treat?
• Does the facility accept residents who are already receiving hospice services? Are there any limitations to working with seniors receiving hospice services?

Activities and lifestyle

Learn how a facility helps residents stay physically, mentally, and socially active so that you can be sure your loved one will have plenty of engaging options. Find out how an assisted living facility accommodates your loved one’s hobbies and interests by asking the following:

• Are residents happy or satisfied with their lifestyle? How do you measure resident satisfaction?
• Does the facility consider residents’ preferences when offering new activities, clubs, or events?
• Are residents actively encouraged to participate in activities?
• What types of activities are available to residents? How often do they occur? Is there a calendar of events?
• Is live entertainment provided? If so, what kind and how often?
• What amenities are available (e.g., media center, fitness center, spa, and barber shop)?
• What common spaces are available to encourage gathering (e.g., dining rooms, lounges, game rooms, and event halls)?
• Is the decor of shared areas intentional? Does it promote comfort and nostalgia through features like uplifting colors, art, and comfortable furniture?
• What outdoor spaces does the community have (e.g., walking paths, secured courtyards, and gardens)?
• Are there shared community pets, such as dogs, cats, birds, or fish?
• Is there a place where residents can do their own gardening, arts and crafts, or other personal hobbies?
• Does the facility collaborate with the surrounding community for events (e.g., local libraries, parks, and schools)?
• Do residents go on regular outings?
• Do volunteers come into the community?
• Does the community offer any religious services on-site or transportation to services in the area? Is the community affiliated with a particular religion? Or is there a large group of residents who share a common religion on-site?

Dining services

It’s important to ask about on-site dining services to understand how your loved one’s dietary needs and tastes will be met. Ask the following questions to ensure the community can support your loved one’s needs and preferences:

• How many meals are provided per day?
• Are mealtimes set, or can residents dine anytime?
• Does the menu change daily? Is the food prepared daily?
• Does the facility tailor meals to residents’ specific dietary needs, restrictions, or special requests?
• Are residents permitted to keep or cook food in their units?
• Can you sample meals during a tour?
• Are special meals prepared for specific holidays, birthdays, or other special occasions?
• Does the community provide snacks throughout the day? What kind?
• Is there an on-site café for snacks, drinks, and treats?

Read more:Dishing Up the Facts About Assisted Living Menus and Dining Options

Living preferences and accommodations

Assisted living facilities vary in terms of how much they can accommodate specific living preferences. Ask the following questions to learn more about how a facility meets residents’ unique needs:

• What floor plans are available? What’s the monthly cost of each layout type?
• Do residents have the option of a private or shared room?
• Are couples allowed to live together? If so, how are elderly couples supported?
• Are furnishings provided? If so, what types?
• Can residents personalize and decorate their own units?
• Does each unit have a private bathroom, or are the bathrooms shared?
• Is each unit and bathroom designed to accommodate mobility aids like wheelchairs and walkers?
• Are there in-unit kitchens or kitchenettes?
• Does each unit have good natural lighting?
• Are residents able to control the temperature in their units? If not, how does the facility ensure each resident’s comfort?
• Does each unit have a 24-hour emergency response system?
• Is housekeeping offered? If so, does it include linen and/or laundry service?
• Are pets allowed to live in the community? If so, is there a weight or breed restriction?
• Is there a process for dissatisfied residents to make requests or file complaints?

Assisted living questions? Get expert help

To help you stay organized and keep track of each community’s details, we’ve compiled a handy checklist for assisted living facility tours (this is all of the questions above in PDF format). Print one copy for each community you visit to keep track of the answers. When you’re finished touring all the facilities, compare and contrast your notes to help you and your loved one make an informed decision.

Take full advantage of your time at each facility

“You want to make sure you’re speaking to as many department heads as possible,” Levy recommends. “They’re the ones day in and day out who will oversee your loved one’s care. If your sales director [or other tour guide] doesn’t do this automatically, then you need to ask. Key positions to speak to are the executive director and nursing director, but the maintenance and food service director can also add insights.”

The more people you talk to, the better view of a facility you’ll have. Ask your tour guide who will be available for you to speak with, as your access may vary from community to community. And don’t be afraid to ask for a second tour if you need it.

Of course, the people who may give the best insights into community life are the residents themselves. If you see residents during your tour, ask them what they like about living there.

Expect staff to ask questions too

During a tour, it’s normal for your guide to ask you and your loved one questions as well. In fact, it’s a good sign.

“As a sales director, it was my job to help our customers open up. I’d really focus on [asking] open-ended questions like, ‘What worries you the most right now?’ or ‘What do you think will happen if you don’t make a decision?’” Levy recalls. “I found that families opened up if I told them from the start that I’d be asking a lot of questions since it will help me help them. I always listened for emotional words and then asked them to tell me more.”

The more questions your tour guide and others in the community ask your family, the better. It shows that they care and want to help ensure that the community will be a good fit for your loved one.

Once you gather all the information, it’s time to decide which assisted living facility will best meet your loved one’s needs. Recall what mattered most before you started touring. Do you have different ideas now about which services, amenities, and benefits are essential, which are nice to have, and which your loved one can do without? Talk with your loved one to ensure the facility you choose can meet both your requirements for long-term satisfaction and care.

Consider too whether an assisted living facility is the right move for your loved one. There are other settings and services that may be a better fit, depending on their preferences and needs, such as a nursing home, home care, or a memory care community.

Ultimately, choosing the right assisted living facility comes down to individual needs and preferences, so trust your instincts! And don’t be afraid to ask more questions for extra clarity if needed.

And, of course, you can always talk to a Senior Living Advisor at A Place for Mom. They’ll work with you to find communities that fit your loved one’s lifestyle and budget. Plus, they can help schedule tours. They’re a wonderful source of information and advice as you navigate assisted living solutions. Best of all, their assistance comes at no cost to you.