Choosing a new home does take time and careful consideration. Being able to identify some key focus areas is very helpful if possible as many individuals are uncertain and not clear about what is important to them when initially looking for a new home.
We have provided some questions below that can often times be helpful. This is a long list so clearly not all areas may need to be addressed or inquired about.
We also recommend visiting the community multiple times and at different times - visiting for lunch and or attending a community program can be helpful to see the current resident population, staff interaction, dining and program quality, responsiveness, etc.
We recommend asking lots of questions and taking time to gather and consider all information before moving forward. Once you identify the right location the rest can be operationalized timely and fairly easily with support. Although it may seem to be a lot to manage this can be streamlined and made very simple - we assist with these aspects for many families to ensure all aspects are handled efficiently and effectively!
Move coordination, transition planning, packing, unpacking ,organizing, staging, estate sales, decluttering, junk removal, donation, and more can all be handled by our team in collaboration with our trusted service partners! Special guidance and considerations are also made for those with cognitive impairment to minimize and eliminate relocation trauma and help facilitate timely adjustment.
Some Questions to Consider Asking when Touring:
What will most days be like - what are common outings, events, activities, dining?
What is their current occupancy? Max occupancy?
How will they get to know you and help you to settle in? What is the welcoming process on move in?
What does move in day look like- what elevators are accessed, etc?
Any restrictions on move in times and days? Items?
How do you file a maintenance request and how timely are these processed / remedied?
How are after hours, weekend, or emergency requests handled?
Who is a 24 hour contact for property?
Do you need renters insurance? (Probably yes and can advise on this).
What are transportation options? Are these at an addition charge? Any area or milage restrictions?
What is the policy for facility flooding or other structural challenges that can occur? Who is the responsible party?
Is there storage space available? Size? Is there a fee for this?
Is there ample guest parking and location?
Parking spaces - is there a charge for resident parking?
Are there any renovation plans of the property? Specifics?
Ask about rental specifics - Amount, additional fees, any penalties for breaking lease? Specifics for down payment, community fee, giving notice , early terminations allowed, late payment penalty? Waitlist? Length?
How often are rent increases considered? When was the last increase done and what was the percentage / amount?
Details about apartment and building security aspects?
What amenities are included and what amenities are an additional charge?
How does community determine a need for assisted living? Can this be supported in an independent living apartment or does this require relocation within the community?
How is resident centered care coordinated in assisted living?
What happens if a resident needs to stay in their room due to illness; how is socialization addressed?
What is your organization’s policy regarding the use of “agency” nurses and “agency” CNAs (people who are brought in from the outside who are not your regular staff)?
How do you ensure quality of these staff? Will level of care fees be lower if having private duty performing aspects of care? How will staff roles be clarified for this?
Can I or my family member stay there long term and age in place? Are there any care restrictions, etc?
In assisted living how are the levels of care defined? How often are they reassessed? Cost for levels?
What will be done to help the resident adjust if having difficulties?
Continuity of care - do the CNA's / nursing assistants take care of the same group of residents each time they work, or do you rotate the assignments after a period of time? How is the schedule and resident assignments made?
How is information regarding residents communicated from shift to shift?
What are the hours that a nurse - RN or LPN are onsite - outside of a nursing or Health services director?
What services can be provided on site? (Beauty, MD/ NP, podiatry, psychiatric, eye, dental?)
Who makes staff assignments?
How are staffing ratios determined? How often are they reevaluated? What are the ratio's of staff to residents?
Is dining all day access and flexible time wise?
What if we want to dine in our apartment Is there and additional charge for in room dining / delivery?
What is your policy regarding food choices and alternatives?
What type of recreational activities are offered here?
How do you build a sense of community, and give those who live here a voice in the decisions about how things are done?
How do you meet the special needs of people who have some type of cognitive impairment or dementia?
What is the staff training? Type and how often?
Can those with cognitive impairment be supported outside of memory care?
What are the criteria for memory care?
Do you have geriatric psychiatry? How often do they visit and which groups?
What physican groups provide services onsite? How often do they visit the community?
What are the choices for skilled services and which rehabilitation team do you have a relationship with for access to therapists such as speech pathologists, physical therapists, and occupational therapists? What is the process for choosing a group outside of this? Do you have a gym area specifically for rehab services onsite?
If hospice or palliative care is needed does your community refer to any specific organizations?
How are staff roles coordinated / defined between outside agencies and the community staff?
What is the role of residents and family members? Do you have a Resident Council, Family Council, or support group meetings? How are concerns to be voice and through what mechanism?
Do you have general resident meetings, how often?
What clubs are available? What is the process for forming new clubs?
Do you measure the turnover of your staff (defined as the average percentage of staff who stop working at the home each year)?
If so, what is the turnover rate for your direct care workers (CNAs, nurse assistants)? Shoot for any number under 40 percent. (The national average is 66 percent.) Licensed nursing staff? Aim for any number under 30 percent. (The national average is 41 percent for RNs and 50 percent for LPNs.)
Do you measure staff satisfaction, family, resident satisfaction?
How often do you measure the satisfaction of these groups?
If yes, what do you do with the satisfaction survey results?
How is quality of care measured? Do you have any current deficiencies cited? How are these areas being addressed and corrected?
What is your mission statement? Are staff able to share the mission in their own words and indicate that it is meaningful to their work? Is it posted?
Are pets allowed? Which type?
What is the visitor policy? Are their any restrictions on visitation under any circumstances?
What is the security at night? Are doors locked, supervision, night time checks?? During the day?
What is the policy for checking on residents at night?
Are their cameras in the community? Can you add cameras in your apartment?
Who do I contact if there is a quality of care issue? How will this be handed and resolved?
What quality control mechanisms are in place to ensure that staff are doing resident care and checks? How is this documented and evaluated?
What happens if my family member has less than three years of funds? Will the community help in planning and moving forward with care? Do they have a samaritan program? (Care management also assists with these aspects if needed).
To get an overall Impression of the community observe the following:
What is the culture? Happy, relaxed, busy stressful, clinical?
What are the staff education programs? Family support and education programs?
Are staff and residents interacting with what looks like interest and kindness?
Are resident behaviors ever ignored by staff when repetitive or are they acknowledged? Are they appropriately and kindly redirected?
Do staff come across genuine or like sales people? What is your gut feeling?
Look at the furnishings, condition of facility, colors, furniture, walls, floors, lighting, real or artificial plants, bird cages, fish tanks, pets, smells, lighting, signs, postings, elements of privacy, options for sitting alone, activity areas, transportation vehicles, conversation areas, private dining rooms, and resident facial expressions.
Are there decor items and a flow that helps with cueing residents to appropriate aspects of their day, surroundings, etc.
Look at the types of resources and activities that are posted. Are cultural elements present?
Check to see if Resident Council and Family Council materials, and ombudsman contact information, are posted in clear, obvious places and at a level where a person in a wheelchair could read them.
Look for the most recent report of the state survey. You can ask to have a copy of this also as it should be made available for you to review. (We can help with this).
Talk to residents and families when you are visiting. Do not rush. Try to comeback without an appointment...pop in! See the community as it really is!
Ask residents how they feel about their home and if they would recommend it to others? Try not to ask this in the presence of a staff person as residents may fear sharing negative comments.
You want to ensure that you get an accurate impression! Finally, if it does not feel like the right fit, it probably is not!!!
We hope that the above helps! Please reach out with any needs as our team is here to help!
Remember that the needs of most individuals can be met in assisted living! Skilled nursing is only needed under special circumstances!
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