Questions to Ask an Assisted Living Facility
For an adult child or a future resident touring assisted living communities and comparing them before signing anything. The questions follow the order of a visit: care and how it is assessed, staffing, daily life and the apartment, cost, the contract and moving out, and what to see and whom to talk to on the tour. Each has a note on what a solid answer sounds like and what should make you slow down.
Want questions from the whole vault instead? Try the random question generator.
The questions
Each question, and why to ask it
Care
What levels of care are there here, and what is included at each one?
Why ask it
Communities name their tiers differently (levels, points, packages), so ask for the written description of each one. A useful answer is a list of tasks: help in the shower, getting dressed, an escort to meals, managing pills. If the levels can only be described as light, moderate and heavy, you cannot tell which one you or your parent would land in.
Who does the assessment before move-in, and what does it look at?
Why ask it
It should be someone clinical, such as a nurse or the wellness director, who meets the future resident in person. Ask for a blank copy of the form: it shows what gets scored and how the score becomes a care level. Be wary when a salesperson quotes a level before anyone has done the assessment.
How often are residents reassessed, and what can trigger it between reviews?
Why ask it
Listen for a schedule plus events: a fall, a hospital stay, a change the aides report. Then ask whether the family hears before the reassessment or finds out when a higher rate appears on the bill. Ask too whether anyone's level has ever gone down, after a recovery for instance.
What kinds of care can you not provide here?
Why ask it
Every community has a ceiling, and what its license permits differs from state to state, so ask for theirs in plain terms: two people needed for a transfer, injections, oxygen, a feeding tube, a resident who wanders. A specific list is a good sign. 'We can handle almost anything' should worry you, because the limit exists whether or not anyone names it.
How are medications managed, and who actually hands them out?
Why ask it
Who is allowed to give medication, a nurse or a trained aide, depends on the rules where you live, so ask how it works in this building. Have them walk through one resident's morning: where the pills come from, who checks them against the prescription, what is written down, what happens when a dose is refused. If the resident still manages their own pills, ask whether that can continue and who reviews it.
Do you have residents now with needs like my mother's, and how are they managing?
Why ask it
Name the specifics first: insulin, Parkinson's, a walker, early memory loss, incontinence. The answer you want mentions people living there today and what staff do for them each day. A long pause tells you something as well: a building full of fairly independent residents may not be staffed for more.
Can residents keep their own doctor and pharmacy, and which clinicians visit the building?
Why ask it
Some communities require their contracted pharmacy for anyone on the medication program, or charge for repackaging pills from elsewhere. Ask which doctors, therapists and foot or dental services come in, and how a resident gets to a specialist who does not. Skip the pharmacy half if the resident will manage their own medication.
What happens when a resident falls or becomes unwell during the night?
Why ask it
Ask to hear it step by step: who gets to the room, who decides whether to call an ambulance, when the family is phoned. Some buildings send every fall to the emergency room and others assess first. You can live with either policy, but find out which it is now and not from a call at 2 a.m.
Who writes the care plan, and can the family read it and ask for changes?
Why ask it
The plan (some communities call it a service plan) is what an aide on an unfamiliar shift goes by, so it should hold the small things: showers in the evening, hearing aids in before breakfast, which knee is the bad one. Ask how often it is updated and whether you can have a copy. If families never see it, nobody outside the staff is checking it.
How will you tell us when something changes, and who is our contact?
Why ask it
Get a name and a job title, not 'the front desk'. Find out what prompts a call (a fall, a new prescription, a trip to the emergency room) and whether routine notes are shared in an app or a log. If you live far away, ask how quickly a question that is not urgent gets an answer.
Staffing
How many residents does each caregiver look after on the day, evening and night shifts?
Why ask it
Ask for three numbers, and ask whether they count only the people giving hands-on care or the cook and the receptionist too. Any required minimum varies by state, and no single figure is right, so compare the answers between buildings whose residents need about the same help. Notice whether the night number comes as readily as the day one.
Who is in the building overnight, and are they awake?
Why ask it
You want the head count, what those people are trained to do, and whether any of them can give a medication at 3 a.m. Whether night staff must stay awake depends on local rules and the size of the home. One aide covering several floors means a long wait when two residents need help at once.
Is a nurse on site, during which hours, and who is on call the rest of the time?
Why ask it
Assisted living is not a nursing home, and whether a nurse has to be present at all is set by the state. The practical point is who makes the judgment call on a Sunday night: a nurse by phone, an aide following a protocol, or an ambulance crew. Ask as well whether the nurse does hands-on care or mainly assessments and paperwork.
How long has the executive director been here, and how much of the care staff has left in the past year?
Why ask it
Some turnover is normal in care work, so do not expect zero. A director who knows the figure and can say what they are doing about it is ahead of one who answers 'we are like a family'. If the building has changed owner or management company lately, ask what changed for residents afterward.
Will the same aides work with my parent most days, or do assignments rotate?
Why ask it
A regular aide learns that your father takes his tea before his pills, and is the first to see that he is walking differently. Ask whether staff are assigned to a hallway or moved around, and how many shifts are filled by agency workers who are new to the building. For someone with memory loss, familiar faces matter even more.
What training do caregivers get before they work alone, and how much of it is about dementia?
Why ask it
A count of training hours tells you little, so ask what a new aide does in the first week and who they shadow. On dementia, listen for practice and not course titles: how to approach someone from the front, what to do when a resident refuses a shower.
What checks do you run before hiring someone, and who holds a key to a resident's apartment?
Why ask it
Aides, housekeepers and maintenance workers all go into a private apartment, often while the resident is down at lunch. Ask what screening a new hire goes through (what is required differs from place to place), whether it covers agency staff, and whether entries are logged. Then ask what was done the last time a family reported cash or jewelry missing.
How does a resident call for help, and how long does it usually take someone to come?
Why ask it
It might be a pendant, a pull cord or a button on the wall, so ask which, and whether it works in the shower and out in the garden. Many systems log response times, and a manager can show you last month's figures if they want to. 'Right away' is not a number.
Daily life and apartment
When a resident needs help getting up, dressing or showering, who decides what time that happens?
Why ask it
Morning help is where staffing shows, because one aide cannot be in six apartments at eight o'clock: somebody is dressed early and somebody waits. Ask how the order is set and whether a late riser or an evening shower can be written into the care plan. Find out what happens to breakfast for whoever is helped last.
Can we stay and eat a meal in the dining room?
Why ask it
A meal shows what a menu cannot: whether the food arrives hot, whether anyone helps the person struggling with a fork, whether the tables are talking. Sit with residents if you are invited to. A community that sells its dining and will not seat a visitor deserves a second thought.
What happens when someone dislikes the meal, misses it or needs a special diet?
Why ask it
Ask what is always available besides the day's choices, whether a tray can go to the apartment and whether that costs extra. For a diabetic, low-salt or pureed diet, ask to see today's version of it. The best answers include who notices when a resident has skipped two meals running.
Could we see this month's activity calendar, and which events actually draw a crowd?
Why ask it
A calendar in the lobby is easy to print. Check what is listed for the hour of your visit against what is happening in the room as you pass. Count the things your parent would go to, not the number of entries: a card game, a garden bed, a ride to a service in their own faith.
What do you do about a resident who rarely leaves their apartment?
Why ask it
Moving in does not end loneliness, and some people withdraw in the first months. A good answer has a person in it: someone who knocks, learns what the resident likes and walks them to the first few events. 'We respect their choice' is right as far as it goes, and it can also be how nobody notices.
What transportation do you provide, on which days, and what does it cost?
Why ask it
A common arrangement is a van to medical appointments on set days within a set distance, with anything else left to family or a paid ride. Ask whether an aide can go along and stay, since a resident dropped at the door may not manage the appointment alone. If the resident still drives, ask about parking.
Which apartments are open now, and can we see the exact one and not the model?
Why ask it
The model is furnished to look its best, so in the real unit walk the route to the dining room at a walker's pace, listen for the elevator or the kitchen, and look out of the window. Ask what explains the price difference between two units of the same size. If nothing is open, ask how the waiting list works and whether money paid to join it comes back.
What safety features are in the apartment and the bathroom, and can more be added?
Why ask it
Look for grab bars, a shower with a seat and no step, good light, and a call button that can be reached from the floor. Check that a wheelchair could turn in the bathroom even if nobody needs one today. If something is missing, ask who installs it and who pays.
What can residents bring from home, and are pets allowed?
Why ask it
Their own bed, chair and pictures do a lot to make a new room feel familiar, so ask what is not allowed: loose rugs, space heaters, a microwave. For a pet, get the fee, any size limit, and what happens once the resident can no longer walk the dog. Ask too whether staff help hang pictures and set up the television, or whether move-in day is all the family's job.
How would staff know if a resident had not come out of their apartment all morning?
Why ask it
Buildings do this in different ways: a knock at a set hour, a list of who missed breakfast, a sensor on the door. What you are after is a routine that does not rely on someone happening to notice. Ask what staff do when a knock gets no answer.
How are the entrances secured, and when can family visit?
Why ask it
Residents of assisted living generally come and go as they like, so ask how staff know who is out, who can walk in off the street and when the doors lock at night. Visiting at any reasonable hour, evenings included, is what to hope for. If your relative sometimes gets lost, say so and ask at what point the building would call an open door unsafe.
What is the plan for a fire, a power outage or severe weather?
Why ask it
Ask whether there is a generator and what it runs: elevators, heating and cooling, the kitchen, oxygen equipment. Then ask how residents who cannot manage stairs get out. A manager who has lived through an outage will tell you what went wrong that day, and that story beats any binder.
Cost
What would the whole monthly bill be for my parent, with rent, care and every regular fee added together?
Why ask it
The advertised price is often rent for the smallest apartment with no care included. Ask for one itemized figure based on the assessment, on paper, with a date on it. Until you have that from each community, you are comparing guesses.
What does the base rate include, and what is charged on top of it?
Why ask it
Go down a list out loud: meals, housekeeping, laundry, utilities, internet, the call pendant, medication management, incontinence supplies, an escort to the dining room. For each 'extra', ask for the printed price. Two buildings with the same headline rent can end up far apart once these are added.
Is care priced by level, by points or by the task, and what does the next level up cost?
Why ask it
Get the dollar figure for every tier, not only the one that applies today. Paying by the task looks cheap for someone independent and climbs quickly; an all-inclusive rate costs more at the start and moves less. Work out the bill for a year in which help with bathing and dressing is needed every day.
How much have rent and care charges gone up in each of the last three years?
Why ask it
Ask about both, because rent and care rates can rise separately and at different times of year. Three years shows a pattern that a single year hides. Then check whether the agreement limits increases at all or only promises notice of them.
What do we pay before move-in, and how much of it comes back if plans change?
Why ask it
A one-time community fee and a deposit to hold the apartment are two different payments, so ask what each is for and get the refund terms in writing. Put the hard cases to them: a hospital admission before move-in day, a death in the first month, a resident who is unhappy after three weeks. These fees are sometimes reduced when a building has empty apartments, so it is fair to ask.
If my parent outlives their savings, can they stay?
Why ask it
Whether a public program helps pay for assisted living (in the US, Medicaid does in some states) depends on where you live and on whether this building takes part. Ask whether they accept it, whether a resident must pay privately for a set time first, and whether the number of places is limited. If the answer is no, work out how many years the money lasts at rising rates before you sign.
Do you work with long-term care insurance or veterans' benefits, and who handles the paperwork?
Why ask it
The insurer or the agency decides what is paid, not the community, so bring the policy and ask what records the office has supplied for other residents. Someone in the business office who sends care notes and invoices every month saves a family hours. Where nobody has dealt with a claim before, plan on doing it yourself.
How does the price work for a couple, especially if one of us needs more care than the other?
Why ask it
Many communities charge a second-person fee plus a care charge for each of you, so ask to see it worked out. The harder questions come next: what happens to the rent if one partner dies or moves to memory care, and whether the other would have to change apartments. Skip this one if the move is for one person.
Contract and move-out
What would make you tell a resident they have to move out?
Why ask it
Ask for the wording in the agreement and then for real examples from the past year. Needs beyond what the license allows, behavior that puts others at risk and unpaid bills are the usual grounds. A clause as loose as 'needs we can no longer meet', which nobody in the office can define, leaves the decision entirely with them.
If you asked a resident to leave, how much notice would we get, and could we appeal or bring in extra help so they can stay?
Why ask it
Notice periods and any right to appeal come partly from state rules and partly from the contract, so ask where each is written down. Find out whether hiring a private aide for some hours would be accepted as a way to stay, and what rules or fees apply to outside caregivers. Ask also whether staff help find the next place or simply hand over a date.
Do you have memory care on site, and what decides when someone moves into it?
Why ask it
Ask who makes that call and on what evidence: getting lost, trying to leave, incidents at night. Mild memory loss does not always mean memory care, so ask how many current residents have it and live on the assisted living side. With no memory care in the building, a later move means a new address and all new faces, which matters if there is already a diagnosis.
How does memory care differ from this side of the building in staffing, doors, daily routine and price?
Why ask it
Walk through it even if it is not needed yet. See whether residents are doing something or lined up in front of a television, and ask for the staffing numbers and the dementia training there. Get the price today, and ask whether current residents go ahead of outside applicants when a room opens.
If a resident goes to the hospital or to rehab, what do we keep paying, and what has to happen before they return?
Why ask it
Rent usually continues while the apartment is held, so ask whether care and meal charges stop for those days. The return is the bigger question: a community may reassess before a resident comes back and say the needs are now too great. Ask who does that assessment and whether they will visit the hospital to do it.
Can hospice or home health care come into the apartment, and do residents usually stay here until the end of life?
Why ask it
Families often assume this move is the last one. Whether outside nurses can work in the apartment, and how much care a community may keep someone with, depends on its license and its own policy. Ask how many residents moved on to a nursing home last year and why.
How much notice do we give if we decide to leave, and what is owed after a resident dies?
Why ask it
Check whether the notice clock starts on the day you give it or the day the apartment is emptied. After a death, ask how long the family has to clear the rooms and whether rent runs until they do. Read this clause yourself instead of taking a summary, since it applies at a time when nobody wants to argue about a bill.
Can we take the residency agreement, the fee schedule and the house rules home before we pay anything?
Why ask it
A plain yes, with copies in your hand that day, is the right answer. Read the agreement with the fee schedule next to it, because contracts often point to fees 'as amended'. Take anything you do not follow to someone qualified, such as an elder law attorney, and look closely at who signs as responsible for payment and how disputes are settled.
On the tour
What is this community licensed as, and can we read the most recent inspection report?
Why ask it
The license goes by different names from state to state, and so does what it permits, so ask what theirs allows and where inspection reports are published. A report shows what was cited and how the community responded. A director who hands it over and talks through the citations is doing better than one who says there has never been a problem.
Could we see parts of the building that are not on the usual tour?
Why ask it
The sales route runs past the best rooms. Ask for another floor, the far end of a hallway and the laundry, and notice the smell, the carpet and whether call lights are blinking with nobody on the way. Listen to how staff talk to residents there: by name and at eye level, or over their heads.
May we talk to a few residents and a family member without staff standing by?
Why ask it
Ask residents what they would change and how long it takes when they press the button. Ask a relative how they heard the first time something went wrong. A community that is sure of itself makes the introduction and walks away.
To an aide, if one has a minute: how long have you worked here, and what happens when someone on your shift calls in sick?
Why ask it
Ask it kindly and do not keep them long: they are at work. A shift that is one person short is when care gets thin, and an aide can tell you whether a manager comes onto the floor, an agency worker is sent or the hallway is split between whoever came in. If every aide you meet started this year, the turnover figure from the office was optimistic.
What do residents and families complain about most, and what changed because of it?
Why ask it
There is always something: the food, laundry that goes missing, weekends. A director who names the complaint and the fix is being straight with you, and 'nothing really' means nobody asks or nobody is telling. Ask whether there is a resident or family council and whether you could read its last minutes.
Can we come back unannounced in the evening or on a weekend?
Why ask it
A booked tour shows the building on a weekday with the full day shift in. After six, or on a Sunday, you see the thinner shifts: who is at the desk, how dinner is going, whether half the residents are already in bed. The answer should be 'of course'.
Is a short respite or trial stay possible before we commit?
Why ask it
A week or two in a furnished apartment shows what no tour can: the nights, the food on day five, whether anyone has learned the resident's name. Ask the daily rate and whether it is credited toward the community fee afterward. A parent who will not agree to a move will sometimes agree to a trial.
How to compare assisted living communities before you sign
Practical guidance for the conversation itself
Before the first tour
Write down a hard day
List what the future resident needs help with on a bad day, not a good one: getting out of the shower, remembering the evening pills, finding the way back from the dining room. Every answer about care levels and price depends on that list, and you will be describing the same person to each community.
Settle the basics by phone
Before driving anywhere, ask for the price range, whether an apartment is open, and whether the building can take the conditions on your list. A ten-minute call rules out places that cannot work and saves the visit for questions that need a walk around.
Decide how the future resident takes part
If the move is for a parent, their opinion of the place counts for more than yours. Some families visit first and bring the parent to the two best; others go together from the start. Either works. Touring five buildings in one day with someone who tires easily does not.
Choose what to ask in the room
The fee schedule, the agreement and the inspection report can all be requested by email. Save the hour in the building for what paper cannot show: how the night is covered, what they cannot do, how a fall is handled, how the staff speak to the people who live there.
While you are in the building
Arrive at a mealtime
Book the visit for late morning and stay for lunch, or come at five and stay for dinner. The dining room is where you see most of the residents and most of the staff at once, and it is the busiest hour for the people giving care.
Watch the people more than the lobby
A chandelier and a coffee bar are there for visitors. Look at the residents: dressed, glasses on, busy with something, or asleep in a row of chairs. Look at the staff: whether they know names, and whether they stop when someone speaks to them.
Use the same sheet at each building
By the third tour the answers blur. Write the night staffing, the price of each care level and the grounds for a move-out in the same place on the page every time, with the name of whoever told you.
Leave without paying
Take the agreement, the fee schedule and a blank assessment form home. An apartment that is right can wait a few days while you read, and a deposit paid in the lobby is harder to get back than to hold on to.
Comparing the communities you liked
Price the same person at each
Ask every community for the full monthly figure for the needs on your list, not its starting rate. Then add what one includes and another bills for separately: laundry, medication management, the pendant, rides to appointments.
Price two years from now
Take each building's charge for one care level higher and its recent increases, and work out the bill two years on. The cheapest place today is not always the cheapest once more care is added, and the later figure is the one the savings have to cover.
Read the agreements side by side
Compare four clauses: the grounds for asking a resident to leave, the notice each side gives, what is owed during a hospital stay, and how rates may change. If one community spells a clause out and another leaves it loose, ask the second to add its answer to the agreement.
Check outside the building
Find out which agency licenses assisted living where you live and whether its inspection and complaint records are public. In some places an ombudsman for long-term care residents will also talk to families. If the record shows something the director left out, ask about it before you go any further.
When to cross a community off
A deposit wanted today
Apartments do get taken, and an honest salesperson will say when someone else is looking at yours. A discount that ends tonight is pressure, and a move made under pressure is hard to undo.
No straight answer on care pricing
If nobody can show you what each level costs and how a resident is placed in one, the bill can change in ways you have no means of checking. An answer that is vague before move-in seldom gets clearer afterward.
Promises that are not in the agreement
'She can stay here for the rest of her life' and 'rates hardly ever go up' are worth what the contract says about them. Ask for any assurance that matters to you to be written in, and treat a refusal as the real answer.
Things you were not allowed to see
A floor that is being cleaned, a report that is in someone else's office, residents who are never free to chat: one of these is bad luck. Two or three is a building managing what visitors find out.