Housing Choices
Asking the Right Questions of Assisted Living Facilities
Course Section
- Introduction
- How to Determine the Best Housing
- Assisted Living: What to Consider
- Asking the Right Questions of Assisted Living Facilities
- The Contract: Assisted Living
- Knowledge Test
Assisted living facilities are not defined or regulated by the federal government; regulation and licensing is at the state level. Find out from your local Area Agency on Aging or your state health agency how your state oversees them. Don't assume that a state license assures quality care. It is also a good idea to check with your state licensing agency and long-term care ombudsman's office, which advocates on behalf of residents in long-term care facilities, to see if there have been any complaints filed against any of the facilities on your list.
When you have a complete list of facilities, make sure each is properly licensed by the state. Cross unlicensed facilities off your list. Now start making calls.
Making Calls
Once you have a list of residences to visit, make a telephone call to each one. Remember that the person you speak with will most likely be a marketing or sales representative whose job is to promote the residence.
Think about what is important in a facility, such as location, size and types of services provided. When you call, ask questions such as these to help focus your search and save you the time of visiting facilities that won't suit your needs.
- How big is the facility and where is it located?
- Are different sizes and types of units available? Are they equipped with kitchens or kitchenettes?
- Are all of the rooms private? Are bathrooms private?
- Does the facility offer special care or have special care units, such as those serving people with Alzheimer's disease?
- Is a contract available that details all fees, services and admission and discharge provisions?
- Is there a written plan of care for each resident, and are additional services available if a resident's needs change?
- What role does the resident have in developing the plan of care?
- Can residents choose their own doctors, therapists and pharmacies?
- How does the facility bill for services?
- What happens if a resident runs out of money?
- Under what conditions would a resident have to leave the facility?
If you are still interested when you are through with all of your questions, ask the staff person to send information about the residence. Ask for brochures; a price list; a map or floor plan; a copy of the residents’ rights and rules; and copies of all the documents that will need to be signed before being admitted to the residence, including, most importantly, the contract. Some residences may refer to their contract as residency, occupancy, or admission agreements. Once you receive the materials, review them carefully.
Compare the information in the sales brochure with what's in the contract, especially with regard to fees, levels of care, nursing supervision and discharge policies. Services that a facility promotes in a brochure should also be described in the contract. If you find discrepancies, clarify them with staff as soon as possible. Write down all questions that come to mind so you won't forget them later. Make sure the contract clearly explains all charges and fees.
If a facility refuses to send a contract in the mail, always request a copy during your visit. It is not a good sign if a facility will not provide a contract until a potential resident is ready to sign up. A quality facility encourages a potential resident to review the contract in advance. Never sign a contract the day you visit. Before making a decision about a facility, take the contract home and review it thoroughly, preferably with a lawyer and family members.
Visiting several assisted living facilities is the best way to understand what's available, to see what each is like and to ask questions of staff and residents.
The Visit
There are many questions to ask and details to note when choosing an assisted living facility. Before visiting each facility, make a list of questions so later you can compare notes from other facilities and be sure that all your concerns are addressed.
Take a copy of this printable checklist which is designed to help you choose the right facility to meet your needs. Be sure to add the additional questions that address your particular needs. Fill out a copy of this checklist for each facility you consider. You may also want to attach the price list and the contract for each facility to help you make a careful and informed comparison.
While physical appearance is important, don't be sold on a residence because of its country kitchen, spacious sun porch, or antique furniture. Ultimately, long-term quality of care and services are most important.
- Are the residents interacting with staff and with one another?
- Do they seem engaged and comfortable, or disconnected?
- Are they participating in activities?
Staffing is critical to the quality of care residents receive.
- What are the staff members like?
- Do they treat residents with respect?
- Are they patient or abrupt with residents?
- Do they seem overworked, harried or unhappy?
- How long have they worked there?
- Speak with caregivers directly and ask them about the facility. Also be sure to ask about their training and experience, particularly if medical services are needed.
- Does the facility have licensed nurses on board? Practical nurses? Or does it rely on untrained aides to do most of the caregiving?
Stay for a meal.
- What is the food like?
- Are menus varied and nutritious?
- Eat with residents and take the opportunity to talk informally with them about what they like most and what concerns them about the facility.
Try to make more than one visit, especially an unscheduled one on a weekend or in the evening.
Once you've met with staff, spoken with residents, toured the facility inside and out, tasted the food, and received answers to your questions, you should have a pretty good sense of whether a facility "feels right" and meets your criteria. But don't get too comfortable; you have more work to do.
Choosing a quality assisted living facility can be a challenge. It can be expensive, and it is a long-term, major life decision. If you are looking for yourself, try not to make the visits and decisions alone. Talk with family members and friends. Learning as much as you can about each of the facilities you are considering is the best way to gain the confidence you will need to be comfortable that you are making the right choice.
AARP Resources
Assisted Living Facility Checklist
A printable checklist to take with you during your visits to assisted living facilities to help you remember and to compare facilities.
Additional Resources
Eldercare Locator
The Eldercare Locator is a nationwide directory assistance service designed to help older persons and their caregivers locate local support resources. The Eldercare Locator can give you numbers for ombudsman programs, Medicaid offices and offices on aging in the state and county where you are looking for long-term care.
National Association of Professional Geriatric Care Managers
This association provides information on locating a geriatric care manager who specializes in assisting older people and their families in making long-term care arrangements.
