BBB Tip: How to choose the right assisted living facility

Choosing an assisted living facility is a big decision. Whether you decide for yourself or a loved one, you want to find a new home that meets all your clinical, financial, and lifestyle needs.

Here are BBB's tips for researching assisted living facilities and finding the best option for you:

How should you choose an assisted living facility?

• Get recommendations. Ask friends, family, and your doctor what assisted living facilities in the area they would recommend. If someone you know lives in an assisted living facility, ask them how they like it. Their experience can give you insight into what facilities have the best reputation in your local area. You can also use the Eldercare Locator, a public service of the Administration on Aging (AoA), to consult with your local agency on aging for information on trusted assisted living centers. Check out BBB Accredited assisted living facilities in your area.
  
  
• Consider your needs. Residents in assisted living facilities usually need help with some basic activities of daily living. These basic activities include bathing, dressing, eating, and getting around. A few assisted living communities specialize in caring for people with specific conditions, such as Alzheimer's disease. The level of care assisted living facilities offer can vary greatly, so consider how much assistance you need and go from there.
  
  
• Consider the cost. Medicare doesn't cover assisted living costs, which is why most people pay with private funds even though it's costly. If you need help paying for assisted living, speak with a financial advisor. Assisted living staff may also be aware of local resources and assistance programs you can use to help lessen the costs.
  
  
• Ask a long-term care ombudsperson for advice. Find your state's long-term care ombudsman program for more information about assisted living facilities in your area. Your local ombudsperson can help you investigate facilities and get to know their track record.
  
  
• Think about location. Facilities close to friends and families are often the best choice. Not only will they allow residents to receive lots of visitors, but employees will also know that their care is under the scrutiny of the resident's visitors.
  
  
• Ask plenty of questions. Before calling assisted living facilities, consider the questions you must ask, as gathered from AARP. These might include some of the following:
  • Costs and contracts:
    • What is included in the base monthly cost?
    • Are there additional fees for services like medication management or transportation?
    • What happens if a resident runs out of money?
    • What is the facility’s policy on rate increases?
    • Is there a deposit or entrance fee? Is it refundable?
    • Can residents be discharged for non-payment or exceeding their care level?
    • How are additional services billed?
    • Are all utilities included in the overall cost of a unit?
  • Care and medical services:
    • Are there personalized care plans for each resident?
    • Can residents keep seeing their current physicians?
    • What happens if a resident's health deteriorates and needs additional care or a hospital stay?
    • What types of medical services are available on-site?
    • Can residents age in place, or will they need to move if their care needs increase?
    • How does the facility handle medical emergencies?
    • What is the medication management process?
    • Are hospice or palliative care services available?
  • Resident life and activities:
    
    • How many residents does the facility accommodate?
    • Are there units with private kitchens and bathrooms?
    • Are the rooms furnished?
    • What personal possessions can residents bring with them?
    • Are pets allowed?
    • What amenities are available to residents?
    • What are the meals the facility serves, and how often?
    • How often are rooms and common areas cleaned?
    • What activities and social programs are available?
    • Are there transportation services for medical appointments or outings?
    • How are new residents helped to adjust and integrate socially?
    • Is there an outdoor space or garden area for residents to enjoy?
    • Are religious or spiritual services available?
  • Staffing and security:
    
    • Are there doctors, nurses, pharmacists, physical therapists, housekeepers, cooks, and activity directors on staff?
    • Does the facility run background checks on staff?
    • What safety features does each residential unit feature?
    • What is the staff-to-resident ratio during the day and at night?
    • What training do staff members receive?
    • How does the facility handle complaints about staff or care?
    • Is there 24/7 security on-site?
    • How does the facility prevent and handle issues like elder abuse or neglect?
    • What is the facility’s emergency preparedness plan for natural disasters or power outages?
  • Visitation and family involvement:
    
    • How often can family and friends visit? Can a friend or family member stay the night?
    • Are there restrictions on visiting hours?
    • How does the facility keep families updated on a resident’s health and well-being?
    • Are family members involved in care planning meetings?
    • Is there a private space for family gatherings?

• Make a checklist. With so many needs to meet and questions to ask, it's a good idea to write everything down. Make a checklist of your most important questions and take it with you when you visit a facility. Write down the answers too. This checklist will come in handy when you start comparison shopping.
  
  
• Be observant when you visit the facility. As you tour a facility, keep your eyes open to the cleanliness, activities, safety features, available common areas, how friendly the staff is, and how healthy and happy the residents seem. Be bold and ask any residents you meet about their experience.
  
  
• Compare several facilities before you decide. Don't just choose the first facility you visit. Instead, tour several facilities and compare them.
  
  
• Carefully review contracts. It's easy to skim long, wordy documents, but it's critical to always read assisted living contracts from start to finish. Keep an eye out for unexpected fees or deposits, so you won't have any surprises when your first bill arrives. In addition, pay attention to the rules regarding discharging or evicting a resident, late, or missed payments, and how the facility handles (or limits) your rights to file a lawsuit should something go awry.

For more information

Visit the BBB resource page for older adults. Learn how to protect older adults from scams and abuse. Read the BBB tip about buying long-term care insurance.