Knowing how to evaluate assisted living, memory care or independent living facilities is absolutely crucial before moving yourself or a loved one into one. The reason: Not all are created equal.
“Just like there are some great senior living providers out there, there are some bad actors in the space,” explains Sheri LaBree, a geriatric social worker and operations manager at Care.com. “Families want to make sure that a senior living community is safe and that it has a good track record of providing good care.”
Further, she notes, someone with cognitive concerns, like dementia, may not be able to communicate if there is a problem. “This means you need to have some trust that they are receiving good care once they move.”
Here, experts explain exactly how to evaluate senior living facilities from the very beginning of your search to the end.
The importance of due diligence when searching for senior living facilities
Putting in the work is “crucial” when searching for a senior living facility for yourself or a loved one, notes Esther Cromwell, founder and CEO of Avendelle Assisted Living in North Carolina, as the decision impacts one’s “quality of life, safety and well-being.”
Since every facility has their own set of unique strengths, services and levels of care, choosing the right one ensures that the resident’s specific health, social and emotional needs will be met, she explains.
“Thorough research helps identify facilities with high standards of care, qualified staff and a positive environment, which reduces the risk of poor-quality care or unexpected costs,” notes Cromwell. “Additionally, understanding the pricing structure and potential for rate increases allows families to budget realistically and avoid financial strain down the road.”
Narrow down your options
Drawing up an initial list of senior living facilities is no small task, as the options (and ways to find options) can feel endless. But both LaBree and Cromwell agree that your first go-to should be talking to friends and family in the community.
“Word of mouth is one of the most valuable resources,” notes Cromwell. “Recommendations from friends, neighbors or colleagues who have personal experience with a facility can provide trusted insights.”
Other vetting tools to consider are online directories, local senior centers or area agencies on aging and Google. “Look at the reviews and actually read them,” LaBree notes.
“For those seeking specific amenities or care types, facilities’ own websites and virtual tours provide a direct look at what’s offered,” says Cromwell. “By drawing on these resources, families can create a comprehensive list of options that meet specific care needs, location preferences and budget constraints.”
Research health and safety standards
Once you have an initial list, and you’ve combed through reviews, it’s time to go a little deeper and research the facilities’ health and safety standards. LaBree recommends seeing if your state offers the past inspection reports for the provider. “Try to get a hold of a copy online,” she says. “If you can’t, you can always ask the provider to see a copy.”
Something to keep in mind: Inspection reports can be complicated to decipher, but doing the work is worth it. “These will give you a good sense of what kind of problems have happened in the past,” notes LaBree. “That said, most providers have at least a few deficiencies, as no provider is perfect.”
But! You do want to make sure certain standards are being met. “If you are looking for a community that provides memory care, it’s important to ask what steps are taken to ensure resident safety, especially if the person moving is at risk for wandering,” adds LaBree.
Other things to look for:
Licensing and accreditation. Facilities should hold valid state licenses and meet local regulations, which families can often verify through the state’s health or aging department, where inspection records and any past violations are available.
Keep in mind, though, this varies from state to state, and not all states require a license, explains LaBree. To further complicate things, each state may call facilities by different names — so you need to know what you’re looking for.
“For example, in Massachusetts, assisted living is simply called ‘assisted living,’” LaBree explains. “But in California, they are licensed as ‘residential care facilities for the elderly.’”
To learn more about licensure, you can either request to see a copy during your tour (more on this shortly). Or, LaBree notes, you can Google: the name of the state + the provider type + licensure.
Staff training. Equally important are staff qualifications and training, explains Cromwell. “Families should inquire about caregiver certifications, staff-to-resident ratios and any specialized training, especially if memory care or advanced support is needed,” she says.
Additional accreditation. While not necessary, Cromwell notes that accreditation from organizations such as the Joint Commission or Commission on Accreditation of Rehabilitation Facilities (CARF) is an additional indicator of high standards and a commitment to quality improvement.
Tour the facility
Touring a facility is a must, and if possible, LaBree suggests dropping in unannounced.
When touring, here are questions LaBree and Cromwell recommend considering:
- How are the staff treating the residents? (Are they being treated respectfully?)
- Are there call lights ringing while staff are at the desk on the phone? (This can help indicate staff-to-resident ratio.)
- Are residents well-groomed?
- Are residents engaged, comfortable and active, or do they appear isolated or neglected?
- Does the place seem well-kept and in good repair?
- When you touch handrails, are they sturdy?
- Are surfaces in common areas sticky or do they seem clean?
- Are there strong odors (which can indicate poor cleanliness)?
- If you are looking for memory care, are there safe and secured outdoor spaces that residents can access?
- Are there safety features, such as security systems, secure handrails and clear, unobstructed pathways
- Do you hear laughter and the sounds of residents being engaged and having fun?
- Imagine yourself living there: Would you be comfortable?
LaBree also suggests talking to a few residents or families while you’re there and asking them how they feel about the care they are receiving.
Also find out about health and wellness support during your tour, notes Cromwell. “Ask about medical support availability, medication management and whether healthcare professionals, such as nurses or visiting doctors, are regularly on-site.”
Choosing the right senior living facility
After you’ve narrowed down your initial options, done your research and toured facilities, it’s time to make a decision.
“I’d recommend making a list of the pros and cons for your top choices with the person who is moving,” says LaBree, who suggests including the following:
- What did you like?
- What amenities are important?
- How important is the location?
“Then consider what you found out about the quality from reading inspection reports, Google reviews and other sources of information,” she continues. “And finally, consider how you both felt when taking the tour. Use all of this information to help you make the best decision.”
It’s also important to review pricing structures, Cromwell notes,” which will help you understand what is included in the base rate versus additional fees.” This, she says, will help in budgeting for the long term.
“Review each facility’s contract with a clear understanding of terms, renewal policies and any clauses related to care level changes,” Cromwell says. “This will ensure there are no hidden surprises down the road.”
And if you’re on the fence, Cromwell suggests revisiting your top choices, ideally at different times of day, to observe daily routines and interactions. This will jog your memory and help give you a better idea of what life at the facility is like.
The bottom line
By doing upfront research, touring facilities, asking detailed questions and comparing options, you’ll be better equipped to make an informed decision that Cromwell says will align with one’s needs and provide peace of mind that the environment will be supportive, safe and enriching.
“Ultimately,” she adds, “choosing the right facility is about balancing practical details with a sense of comfort and trust.”
