Before You Start Touring
Don't just tour the first facility you find. A little preparation helps you compare options effectively and avoid costly mistakes.
Know What You're Looking For
Assisted Living vs. Memory Care vs. Nursing Home
Assisted Living: Help with daily activities (bathing, dressing, meds), meals, social activities. For people who need support but not medical care.
Memory Care: Specialized dementia care with secure environment, trained staff, structured activities. Higher cost, more supervision.
Nursing Home (Skilled Nursing): 24/7 nursing care for medical needs. For people who need medical monitoring, wound care, rehabilitation.
Assess Your Parent's Needs First
| Need |
Level of Help |
| Bathing/showering |
☐ Independent ☐ Supervision ☐ Hands-on help |
| Dressing |
☐ Independent ☐ Supervision ☐ Hands-on help |
| Toileting |
☐ Independent ☐ Supervision ☐ Hands-on help |
| Mobility/walking |
☐ Independent ☐ Cane/walker ☐ Wheelchair ☐ Needs transfer help |
| Medication management |
☐ Self-manages ☐ Reminders ☐ Full administration |
| Memory/cognition |
☐ Intact ☐ Mild impairment ☐ Moderate ☐ Severe (memory care needed) |
| Incontinence |
☐ None ☐ Occasional ☐ Frequent ☐ Total |
| Behavioral issues |
☐ None ☐ Mild agitation ☐ Wandering ☐ Aggression |
Before Scheduling Tours
- Define your budget (what can you afford monthly?)
- Identify must-have location requirements (near family? specific area?)
- Check state inspection reports online (most states publish these)
- Read online reviews (but take with grain of salt)
- Ask friends, doctors, social workers for recommendations
- Plan to tour at least 3-4 facilities to compare
How to Tour Effectively
Tour Strategies
Schedule Multiple Tours
Visit at least 3-4 facilities. Your first tour will teach you what questions to ask. Return for a second visit at a different time (evening, weekend, mealtime) to see the real picture.
Drop In Unannounced
After an official tour, stop by unannounced, especially during evenings or weekends when staffing may be different. What you see without preparation is more revealing.
Bring Someone With You
Two sets of eyes catch more. One person can focus on the tour guide while the other observes residents, staff interactions, and environment.
Talk to Current Residents and Family Members
The facility can control what the tour guide says. Ask to speak with current residents or their families. Their experience is the real story.
What to Observe During the Tour
👃
What does it smell like?
Clean? Institutional? Strong odor of urine or cleaning chemicals? Smells reveal cleanliness and care.
👀
How do residents look?
Are they groomed, dressed, engaged? Or disheveled, parked in front of TVs, asleep? Do they look content?
💬
How does staff interact with residents?
Warm and personal? Or rushed and task-focused? Do they know residents' names? Do they make eye contact?
📢
What does it sound like?
Quiet and peaceful? Chaotic? Are call lights ringing unanswered? Can you hear shouting or crying?
🧹
Is it clean and well-maintained?
Check corners, bathrooms, common areas. Look for dust, stains, worn furniture, flickering lights.
🚪
What's behind closed doors?
Ask to see areas not on the official tour: kitchen, laundry, a random resident room, staff break room.
Questions to Ask: Care & Staffing
Staffing
- What is your staff-to-resident ratio during the day? At night?
- Is there a registered nurse on site 24/7? If not, when?
- What training do caregivers receive? How often?
- Do the same caregivers work with the same residents (consistency)?
- What is your staff turnover rate?
- How do you handle call-outs and staffing shortages?
- Are staff trained in dementia care? CPR? First aid?
Personal Care
- How do you develop care plans for each resident?
- How often are care plans reviewed and updated?
- Can residents choose their own schedule (wake time, bath time)?
- How do you handle residents who resist care?
- What's your policy on incontinence care? Extra charges?
- How are showers/baths scheduled? Can residents choose frequency?
- Do you provide hospice care, or would my parent have to move?
Medical Care
- How are medications managed and administered?
- Who coordinates with my parent's doctors?
- Can outside doctors make house calls here?
- What happens in a medical emergency?
- Do you have relationships with specific hospitals?
- Can you accommodate physical therapy on site?
- What conditions can you NOT accommodate?
Get Specifics on "We Can Handle That"
Every facility says they can handle complex needs. Ask: "How would you specifically handle [exact situation]?" And: "Have you cared for residents with [condition] before? What happened?"
Questions to Ask: Costs & Contracts
Assisted living costs are notoriously confusing. Get clarity before you sign anything.
Understanding the Pricing Structure
- What is the base monthly rate? What does that include?
- Is pricing all-inclusive, or are there "levels of care" charges?
- How are care levels determined? Who decides?
- What triggers a move to a higher (more expensive) care level?
- Are there extra charges for incontinence care? Medication management?
- What's NOT included in the monthly rate?
- How often do rates increase? What was last year's increase?
Hidden Costs to Ask About
- Is there a community fee or move-in fee? How much?
- Are there additional charges for: cable TV, phone, internet, laundry?
- What about: transportation, beauty salon, special activities?
- Are there extra charges if my parent needs more help temporarily (after illness)?
- Is there a fee to hold the room during hospitalization?
- What happens to the community fee if we leave within 6 months?
Contract & Policies
- Can I see the contract before we commit?
- Is there a trial period? Can we get a refund if it doesn't work?
- What is the move-out notice requirement?
- Under what circumstances can you ask a resident to leave?
- What is your policy on care needs that exceed what you provide?
- Do you accept long-term care insurance? Medicaid? VA benefits?
- What happens if my parent runs out of money?
Get EVERYTHING in Writing
Verbal promises mean nothing. If they say "we'll work with you on price" or "we can accommodate that", get it in the contract or an addendum. What's not written down doesn't exist.
Red Flags to Watch For
Trust your gut. If something feels wrong, it probably is. Here are warning signs that should give you pause.
During the Tour
You're not allowed to see certain areas
A reputable facility has nothing to hide. If they won't show you the kitchen, a random resident room, or the memory care unit, that's a major red flag.
Strong, persistent odors
Occasional bathroom smells happen. Pervasive urine odor, heavy chemical smell trying to mask something, or musty/moldy smell indicates problems.
Residents look neglected
Ungroomed hair, dirty clothing, long fingernails, residents in wheelchairs without footrests, residents sitting in soiled clothing, all signs of inadequate care.
Staff seems stressed, rushed, or unfriendly
Staff attitude reflects management quality and workload. Burned-out staff provide burned-out care.
High pressure sales tactics
"This room won't be available tomorrow." "Sign today for the best rate." Good facilities don't need high-pressure tactics.
Evasive answers to direct questions
If they won't give you straight answers about staffing ratios, rate increases, or move-out policies, they're hiding something.
Poor state inspection reports
Check your state's inspection reports online before touring. Repeated violations, especially for care issues, are serious concerns.
Red Flags in the Contract
Vague language about care levels and costs
"Care fees may apply" without specifics. You should know exactly what triggers extra charges.
Non-refundable community fee
Large non-refundable fees (especially $5,000+) with no pro-rating if you leave early. Some is normal; excessive amounts are a trap.
Broad discharge clauses
Language allowing them to discharge for almost any reason with minimal notice. Ask for specific circumstances.
What Really Matters (And What Doesn't)
Fancy lobbies sell facilities, but your parent won't live in the lobby. Focus on what actually affects daily life.
What Matters Most
| This Matters |
Why |
| Staff-to-resident ratio |
Determines how much individual attention your parent gets |
| Staff turnover and consistency |
Consistent caregivers know your parent; high turnover means constant strangers |
| Staff attitude and demeanor |
Day-to-day quality of life depends on caregiver relationships |
| Cleanliness of resident areas |
Reflects actual care standards, not just appearance |
| Food quality |
Residents eat 3 meals a day, 21 meals a week, food matters hugely |
| Engagement of current residents |
Are people living or just existing? This is your parent's future. |
| Flexibility and responsiveness |
Will they adapt to your parent's preferences and needs? |
| Discharge policies |
What happens when needs increase? Will they keep your parent? |
What Matters Less Than You Think
| This Matters Less |
Why |
| Fancy lobby and common areas |
Designed to impress visitors, not for residents' daily life |
| Amenities like salon, fitness room, movie theater |
Many residents never use them; care quality matters more |
| Brand-new building |
New doesn't mean good care; established facilities may have better-trained staff |
| Extensive activity calendar |
Paper calendars can be impressive; actual engagement is what counts |
| Location in a "nice" neighborhood |
Care happens inside; a facility in a modest area may provide better care |
The Real Test
Would you want to live here? Close your eyes and imagine yourself as a resident. How does it feel? That gut sense is often more accurate than any checklist.
Facility Evaluation Worksheet
Print multiple copies, one for each facility you tour.
Cost Summary
Base monthly rate$
Care level charge (if applicable)$
Community/move-in fee$
Other fees noted$
Estimated total monthly$
Rate Each (1 = Poor, 5 = Excellent)
First impression / cleanliness
Staff friendliness & engagement
Resident appearance & engagement
Food quality (if sampled)
Transparency of pricing/policies
Gut feeling: Would I want to live here?
Key Information
Staff-to-resident ratio: Day ______ Night ______
RN on site: ☐ 24/7 ☐ Business hours ☐ On call
Memory care available: ☐ Yes ☐ No
Accepts Medicaid: ☐ Yes ☐ No ☐ Limited
Facility Comparison Chart
Use this to compare your top choices side by side.
Name
Monthly cost (total)
Move-in fee
Staff ratio (day)
RN availability
Room type/size
Memory care?
Distance from family
Gut feeling (1-5)
Pros
Cons
Your Decision
Our top choice and why:
Questions still to resolve before committing: