Suggested Questions to Ask Facility Staff

The following questions are provided to help you think about everything that may influence your decision. You may not find all the questions important to ask, but it is a good idea to take a few minutes to look over the list and circle the questions you do want to ask. This will give you a chance to think about what is most important to you.

Don't be afraid to ask any question, if you think it will help you make a decision about whether a facility is the right fit for you. If you are worried that you will forget to ask something, bring this booklet along with you on the visit. And be sure to take notes about what you see and hear on the visit.

General

• As you arrive at the facility, do you like the outward appearance? Location?
• As you enter the facility and tour, is the decor attractive? Homelike? Clean? Comfortable?
• Did you receive a warm greeting from staff to welcome you?
• As you tour, does the administrator/staff greet residents by name and interact with them warmly and respectfully?
• Are residents socializing with one another and with staff? Engaged in activities? Do residents appear happy and comfortable?
• Are there common areas for the residents/family/friends to socialize?
• Do the residents seem like appropriate companions/house mates for you or your loved one?
• Is the staff appropriately dressed? Friendly? Treating each other in a professional manner? Respectful and comfortable in their interactions with residents?
• Ask some of the staff how long they have worked at the facility. Is it very long?
• How well do the staff respond to your questions?
• Is there a policy about residents' personal pets? Is there a facility-owned pet?

Building

• Is the floor plan easy to follow?
• Is the facility clean, free of odors, and suitably heated/cooled?
• Are stairs and halls well lit, equipped with handrails and exits well marked?
• Are floors of a non-skid material and carpets firm to ease walking?
• Do doorways, hallways, rooms and flooring accommodate wheelchairs and walkers?
• Are the furnishings and fixtures clean, and in good repair?
• Are elevators available for those unable to use stairs?
• Does the facility have a sprinkler system to control fires?
• What security measures does the facility use to protect residents? (e.g., safety locks on doors and windows)
• Are visitors monitored or asked to sign in?
• Is there a beauty/barber shop on the premises? Any other services you might need (e.g., banking, gift shop)?

Living Units

• Are different sizes and types of rooms available? If so, ask to tour a sample of each.
• Are units for single or double occupancy different?
• Are toilet/bathing rooms private and handicapped-accessible? If they are not private, how many residents share these areas?
• Look for call lights/buttons/cords in the rooms and bathrooms. How easily can residents call staff for assistance from each area if they need help?
• How is resident privacy maintained?
• Do residents have lockable doors to their apartments/rooms?
• Are residents able to bring furnishings? What may they bring? Not bring?
• Do all of the units have a telephone and cable TV hookup?
• May residents keep food in the units?
• Is smoking allowed in residents' rooms? Is there an inside and/or outside designated smoking area?

Housekeeping Services

• What exactly are the housekeeping services? Is there dusting? Vacuuming of upholstered furniture and floors? Cleaning of sinks, toilets and floors? Trash collection? Window cleaning?
• How often are apartments/rooms cleaned? Is there planned, more intensive cleaning on a regular basis?
• Does the staff make beds and change bed linens? If so, how often?
• Are there additional costs for housekeeping services?

Laundry Services

• Are laundry services provided? If so, what is included in the service?
• If bed linens are laundered by the facility, does the service include taking the sheets off and remaking the bed?
• Does the facility provide the sheets and towels?
• For facility laundry, does the clothing need to be marked? If so, who is responsible for the marking?
• Do the residents have options regarding how and when their laundry is done?
• Is there a laundry area with clothes washers and dryers for resident use?
• Are there additional charges for laundry services?

Food Service

• What exactly does food service include?
• What is the appearance of the food? How does it taste? Food is a typical resident concern. Plan to eat a meal at the facility. What is your opinion of the meal?
• Ask to see menus that have been planned. Does the facility provide three nutritionally balanced meals per day, seven days per week?
• Does a dietician or nutritionist review the menus?
• What provision is made for residents with special diets and special food preferences (religious and otherwise)?
• What times are meals served? Are meals available outside of the identified times?
• Are the menus posted, so that the residents will know what foods will be served?
• Are there alternate choices comparable to the identified entree?
• What size portions are served? Are second helpings available?
• Does the facility provide snacks between meal times? How often? What do the snacks consist of?
• Are fresh fruits and fresh vegetables served? How often? Are they available for snacks?
• Are coffee, tea and other beverages available anytime?
• Are residents allowed to invite guests for meals? How much notice is required? What is the charge for guest meals?
• Can residents have meals delivered to their rooms? Are residents served meals in their rooms if they are ill?
• Does the facility provide reminding or assistance with meals? If so, what kind of assistance is provided (e.g., cutting meat, opening bottles)? Is there an extra charge for this service?
• Are there additional costs for meal service?

Medication and Health Services

• Are there Registered Nurses and Licensed Practical Nurses on staff? If so, are they scheduled routinely to be on-site at the facility? When and for how long a period of time? Are nurses available only on an on-call or consultant basis? How often are they available? (Licensing does not require that nurses be on-site at the facility.)
• Will you want help taking medications? Ask if the facility assists with medication provision.
• Do you have special medication needs (such as insulin shots)? Or need special health services (such as checking blood sugars)? Be certain to discuss any special needs during your visit.
• Who provides the residents with medications?
• Is there a choice of pharmacies from which to purchase medications?
• Does a pharmacist review medications for the facility? How often?
• How does the facility assist residents who wish to take their own medication?
• What is the facility's procedure for responding to residents' medical emergencies?
• How are advance directives followed?
• Is help available for setting up medical appointments and for transportation to/from these appointments?
• Do outside health care providers come to the facility? Is a staff person available to coordinate or oversee visits from health care professionals?
• Are hospice services available?
• Are there additional costs for medication assistance and health services?
• Activities of Daily Living (ADLs) and Personal Care Help
• Who determines what assistance the resident needs?
• How is the resident or the resident's designee involved or consulted about the determinations of what the resident's needs are and how those needs will be met? What happens if the resident or resident's designee disagrees with the facility's determination?
• Which staff members provide the actual assistance to the resident? What are their qualifications?
• How many direct care staff are available to help residents during the day? In the evenings? At night? On the weekends?
• If a resident's condition changes (improves or declines), who is involved regarding any changes made in personal care? What happens if the resident or resident's designee disagrees with these changes?
• How often is a resident's physical and mental status and level of functioning evaluated?
• Who does this evaluation?
• Is assistance with showers/bathing or whirlpool bath available? How often? Which staff assists with bathing?
• Are there additional costs for personal care assistance?

Special Needs

• Are residents with special needs, such as Alzheimer's disease and dementia, housed with other residents or do they have special units within the facility?
• Are there separate staff, dining areas and/or activities for residents with special needs?
• How is the staff specifically trained to care for residents with special needs?
• Are there special programs for memory-impaired residents and residents who have dementia?
• Are there special accommodations for memory-impaired residents to be outside? To exercise?
• At what point would the facility no longer be able to meet the needs of a resident with Alzheimer's disease or dementia and seek to transfer the person to a higher level of care (such as a nursing home)?
• Are there any additional costs for a resident with special needs? Social and Recreational Activities
• Is there an organized program of activities that is planned in advance? Ask to see a copy of the activity calendar.
• Who organizes and supervises the activities program?
• What types of activities are offered? When? How do the residents know about the activities? Is there an information board with the activities for the day listed? Are residents given reminders to attend, if they need this assistance?
• What adjustments are made for residents who are visually or hearing impaired, so they can participate in group activities?
• Are religious services/activities offered at the facility?
• Is an exercise program (or equipment) available at the facility? What does it include?
• Is there help for individual activities (such as help with reading/writing for a resident who is visually impaired)?
• Is there a Residents' Council at the facility? How are residents able to present any suggestions to the facility management?
• Are there any additional costs for participation in social and recreational activities?

Transportation

• Is transportation provided? Where to? When is it available to residents?
• How do residents schedule transportation?
• How far in advance is the scheduling required?
• Is the transportation vehicle equipped to accommodate residents with varying levels of physical mobility?
• Is there space for residents to park personal vehicles at the facility?
• Are there additional costs for facility transportation or a personal parking space?

Admission and Discharge Criteria

• What criteria are used to determine whether a person is admitted to this particular facility? (Although state law requires certain overall admission and discharge standards, facilities differ on their specific criteria.)
• What criteria are used to determine when the facility can no longer meet a resident's needs?
• Who has input into a decision that a resident be discharged to another level of care (such as a nursing home)?
• If a resident needs to transfer to another facility, what is the process for transfer or discharge?
• If the resident or resident's designee disagrees with the facility's decision to transfer or discharge the resident, is there a process to discuss/appeal this decision?
• Is the facility a Medicaid Waiver provider, if you or your loved one qualify? Are the same services and living units available to you if you qualify for the Waiver?
• What is the facility's policy for continuing to live there if you switch from private pay to Medicaid Waiver? (e.g., can you stay in the same living unit?)
• Once I have visited assisted living facilities, what are the most important factors in making a decision about where I or my loved one should move?

As you prepare to make a decision about which is the right assisted living facility, keep in mind that the three most important factors are:

1. Your general opinion of the visit (what you saw, how it made you feel, your 'gut feeling');
2. The answers to questions you ask at the visit, and
3. The Resident Service Agreement (the contract for services between you and the facility)