Assisted Living: What to Ask
Residence Name: ______________________________________________________
Check: | First Visit | Second Visit | Date(s)Visited:_____________ |
Morning | Afternoon | Evening |
Circle: | Mon Tue Wed Thu Fri Sat Sun |
You may want to attach the facility’s rate sheet for easier comparison.
The Call:
How many living units are in the residence? __________________________________
Where is the residence located? ___________________________________________
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YesNo
Are different sizes and types of units available? | |
Do any units have kitchens or kitchenettes? | |
Are all the rooms private? | |
Are bathrooms private? | |
Does the residence offer special care units such as those serving people with Alzheimer’s disease? | |
Is a contract available that details fees, services, and admission and discharge policies? | |
Is there a written care plan for each resident? |
What role does the resident have in developing the care plan? ____________________
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Are additional services available on the same campus if a resident's needs change? | |
Can residents choose their own doctors, therapists, or pharmacies? |
How does the residence bill for services? ____________________________________
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What if a resident runs out of money? _______________________________________
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Under what conditions would a resident have to leave the residence?
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The Visit: YesNo
Is the residence clean? | |
Is the residence cheerful? | |
Do you feel good about it? | |
Are stairs and hallways well lit? | |
Are exits well marked? | |
Do rooms and bathrooms have handrails and call buttons? | |
Are there safety locks on the doors and windows? | |
Are there security and fire safety systems? | |
Is there an emergency generator or alternate power source? | |
Is the floor plan logical and easy to follow? | |
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Are rooms large enough for a resident’s needs? | |
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Are there kitchens or kitchenettes? | |
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Are there enough common areas, such as dens and living rooms? | |
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What special services are available? |
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Circle all that apply: bank café beauty salon other (make notes below) | |
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The Contract: YesNo
Is the contract easy to read? | |
Do you understand everything in it? | |
Are specific services provided by the residence? | |
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Does the contract include all of the services you are looking for? | |
How frequently are services provided? ______________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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What do additional services cost? _________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Are health care services included? | |
Which ones? _________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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When and where are meals served? _______________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Are all meals served 7 days a week? _______________________________ |
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Does the contract address levels of care?___________________________ |
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How many levels?
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Who determines level of care? | |
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Are there services for each level? __________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Are linens/laundry provided? _____________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Are transportation services provided? ______________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Is there a parking fee for residents? | |
For visitors? | |
Does the residence offer worship services? | |
Is transportation to worship services provided?_______________________ |
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What are the entrance fee(s)? ______________________________________________ |
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What is the monthly rent? _________________________________________________ |
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What is the security deposit? _______________________________________________ |
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Are deposits refundable? _______________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Are utilities included? | |
Which ones? ___________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Is telephone included? Yes No Long distance? Yes No | |
How are rate increases or late payments handled? _______________________________ |
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Does the contract cover transfer and discharge policies? | |
Who makes a transfer or discharge decision? __________________________________ |
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How much notice is given to residents who have to leave? ________________________ |
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Is the living area held if the resident is in the hospital? | |
For what cost? ________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Can you have a pet? | |
Can you have personal furniture? __________________________________ |
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Does the contract deny your right to bring legal action against the residence for injury, negligence, or other cause? ______________________________ |
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Can you come and go at will? ____________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |
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Can personal visitors come and go at will? __________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ |