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1. If my funds for ALF run out, do you accept Medicaid funds if I need to apply for them? If not, do you assist in my being accepted to a facility that does?
2. What are your levels of care? Usually they are levels I-IV or I-V. What constitutes these levels?
3. Do you work with MD groups/ do you have visiting doctors or medical checks such as blood pressure?
4. If I have appointments what transportation do you provide. Must my medical appointments occur on certain days?
5. What activities do you have. Are there extra charges for any of these activities?
6. Do you allow people with advanced dementia to remain in ALF or is there a MC facility that cares for them?
7. Do you have monthly or periodic meetings in which residents can voice any complaints. If there are complaints, how and to whom do we report?
8. How do meal plans work here? Do we choose menus? If we would rather have a salad or sandwich at a meal can we request such a thing?
9. What is your system for fee increases? What is the average yearly increase in the last five years? Under what circumstances are our levels of care changes?
10. How do your care plans work? For instance, if I don't wish people entering my own room can I ask that they not do so without knocking?
11. Do you have a media concierge who can help me with setup of my laptop, media, TV service; is internet provided?
12. Can you provide me with a tour of the cottages/rooms/choices? What is the cleaning of rooms schedule like? Is my laundry done? Are animals allowed?

Be sure to list any pre-existing problems of yours regarding allergies, mobility, dietary needs and etc and make certain these can be accommodated.
Just a few ideas.
Look online for "What to ask your Assisted Living Facility. You will find suggestions. Be certtain you know what's important for you. For instance my bro had one place with EXCELLENT food and another with beautiful grounds to wander. He chose the later because it was what was important to him. Look online at the facility and see what they offer. For instance, my brother's place had a Facebook page that showed a lot of activities.
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Reply to AlvaDeer
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LoniG1 Aug 18, 2024
Great answers. I only have one issue. No assisted living takes medi-cal. Don't we wish they did. If mom runs out of money you will find the facility hmmm not so nice. However in california and live in a facility for a year and a day you have no more money and your now low income and qualify for ssi medi-cal the facility has to allow you to stay at an ssi rate. Check out CANHR wealth of info. Have you ever thought of volunteering as an ombudsman? You should your what that program needs.
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Alva, 5 star list!!! Esp the “media concierge”.

something I’d like to add is:
- How is the morning “check in” done? Some have it such that every morning aide makes rounds and enters each residents room or suite while others have it that the resident has to place a door hanger outside their room by a set time OTHERWISE staff will enter the room.
If mom has been living on her own for years, having someone come in can be quite an adjustment.
- Is there an additional fee for doing in room meals? Most do and it can add up.
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ElizabethAR37 Aug 18, 2024
Absolutely! I would SO not be happy to have someone I may not know at all enter my room without knocking or announcing themselves. That may not be important to a lot of folks, but privacy has always been a thing with me.
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I’ve recently been helping some friends find an assisted living facility, and through that process, I’ve developed a list of important questions to ask. I’d like to share these questions with you, as they might help you make an informed decision.

1. What is the staff to resident ratio?
2. What types of medical services are available on site?
3. How are care plans developed and updated?
4. How do you handle emergencies and what is the response time?
5. What is your policy on medication management?
6. How do you accommodate residents with specific dietary needs?
7. What kind of activities and social programs do you offer?
8. How do you handle end of life care or residents with declining health?
9. What qualifications and certifications do the staff members hold?
10. How often do staff receive training and what topics are covered?
11. How do you ensure that staff stay updated on best practices in elder care?
12. What measures are in place to ensure the safety and security of residents?
13. Can you describe a typical day for a resident?
14. How do you handle conflicts between residents or between residents and staff?
15. What is your policy on visitors and family involvement in care?
16. What is included in the monthly fee, and what services are extra?
17. How do you handle rate increases?
18. What is the process for transitioning to a higher level of care if needed?
19. What is your policy on refunds if a resident needs to leave the facility?
20. Can you provide references from current residents or their families?
21. How do you gather and address feedback from residents and their families?
22. What is your policy on resident satisfaction and handling complaints?
23. How do you accommodate residents with dementia or other cognitive impairments?
24. How is privacy respected in shared living spaces?
25. Are pets allowed in the facility, and what are the rules regarding them?
26. What is your policy on transitioning residents out of the facility if their care needs change?
28. Does your facility participate in Medicaid and are you part of any waiver programs?
27. What happens if a resident’s funds run out and they need to transition to Medicaid?

Note:
Not all assisted living facilities accept Medicaid, even if Medicaid in that state covers assisted living. It’s important to check with specific facilities to see if they participate in Medicaid and whether they are part of any waiver programs.

These questions should help you get a comprehensive understanding of the facility and ensure it aligns with your loved one’s needs.
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We asked a lot of questions and toured nearly a dozen facilities before moving my parents in, and two months later, out, of an assisted living that cost over $10K/month and was rated "best of state".

Key problems that we encountered are a follows:
1. It often took a very long time for the staff to respond to a call button. Find out if the facility keeps metrics on how long it takes to respond, and whether they have a way to prioritize who gets helped next.
2. The dining room didn't have enough tables and chairs, and my parents had wait for people to leave before they could eat their meals. The staff would tell them to wait, but sometimes they forgot to come back for them. Make sure that there is enough seating for everyone to eat at the same scheduled time.
3. Meals were available in the rooms for an upcharge, but they arrived much later in the evening, and meal components (such as dessert or salad) were sometimes missing. If your loved one will be eating in their room, find out how much extra it will cost and when the meals will be served.
4. The room was not truly ADA accessible. It had ADA features, such as the showers and vanities, but the rooms themselves were too small to be functional for a wheel-chair-bound resident. If this is a concern for your loved one, know the standards before hand, and verify the rooms are legally compliant.
5. Care plan regarding ADLs was not followed. Showers were not provided on a consistent schedule. My parents would grow anxious waiting hours for someone to show up to bathe and dress them so they could on with their day. Ask about frequency and time of day for showers.
6. Housekeeping was not performed on the designated weekly schedule.
7. Staff turnover was high. Find out how long key members of the management team have been at the facility - director, marketing director, nursing director, housekeeping and operations. Our facility had new people in four of these roles.

I know this sounds like a lot, and I feel that we were very reasonable and made good faith effort to resolve our issues. We met with the care team on multiple occasions, but at the end of the day, the problem were not fixed, so we had to move them out.

Remember that things change. I originally toured the facility almost a year before we moved my parents in, and there were some changes that occurred in the interim.

Know that no matter how many questions you ask, you are likely talking to a marketing person whose job is to sell you a room. Period. If it feels like they are waffling on a question, they probably are, so trust your feelings.
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cover9339 Aug 18, 2024
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1. Ask to personally meet the OWNER(s). If that is not possible, it means that it is probably owned by a private equity organization or similar. For them, it is all about pulling out as much profit as possible. If the owner will meet you, they are far more likely to be response-able.

2. Make sure the visiting hours are sufficient. You'll want to see what goes on at night.

3. Do not "join" a continuing care retirement community and get locked into a particular facility (I hate that word.) Only get into a standard rental situation.

4. Make sure an RN is on duty 24/7.

5. Check out the activities.

6. Make sure there is WiFi (for a phone, computer, Echo, or other WiFi devices) or that you can put in your own WiFi.

7. Ask to try out the food.

8. Is it clean.

9. See all the great questions other people have suggested. :-)
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Reply to elisny
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I printed out this list of questions when I started touring assisted living for my mother.

Staffing Questions

What is the daytime caregiver to resident ratio on weekdays?
Weeknights?
Weekends? 
Is there a nurse in the building 24/7?

How many times a day will someone check in on my Mom?

Is her physician allowed to come to her apartment?


Medical Questions
 
What will happen if my Mom is ill?

What will happen if my Mom has a fall?

Will you contact me if you notice that my Mom is not doing well or is ill? 

When and how will that contact be made?


Dining Questions

Do you have all day dining or set meal times?

What if my Mom doesn’t come down for a meal?

What if she is reluctant to go to the dining room? 

What if she isn’t eating well?

Do you have a copy of the menu I can have?

Can she get food delivered via Doordash-like service?
 

Housekeeping Questions

How often is the housekeeping done?

What if she spills something or needs additional help and it's not his housekeeping day? 

How often is trash taken out?

Do you provide toilet paper, tissues, etc?


Assimilation Questions

Who should I call if I notice that my Mom is struggling or unhappy?

How do you help residents participate and feel welcome?


Medical Appointments

How will you help residents with doctor appointments?

Will you provide transportation? 

Will someone accompany her or should I plan to be there?


Activities

How often is transportation for things like shopping trips available?
 
What kind of activities can she participate in? 

How do you help residents participate and feel welcome?

Excursions? Trips?

Can I have a copy of the activity calendar?

Are we allowed to take her on an extended trip, such as a vacation spot?

What are visiting hours?  Can we visit any time?


Services

What are the ala carte services? Costs?

Can she get her own Internet?


Safety

Evacuation plans and policies?

What are your Covid policies?

What is your security like?


Things to observe:

How are the staff and residents interacting? 
 
Do they seem to know the resident?
 
Do the staff seem happy?  

Are they inviting and warm? 

Is the community clean?  

Is everything accessible to your loved one?

Can they easily get to the dining area, activities area?

Does it feel like a place your loved one would enjoy being?
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Reply to darts1975
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First please remember don't judge a book by its cover. Just because it's beautiful doesn't mean the care will be the same. Like all businesses and they are a business they will tell you what you want to hear. Yes miss Jones the used car works great trust me. However i can tell you your ans won't be in the contract. 2nd all facilities are overseen by licensing and the Ombudsman the facility should have posters with their information. All issues the facility may have had are public record. Warning if there is nothing as to public record chances are they have covered something up. If all the facilities in the world were perfect you wouldn't need licensing, ombudsman, nor aps. 3rd. Don't beat yourself up. Just remember VISIT, VISIT, VISIT. living in a facility is a whole new world. If mom has dementia what she states doesn't mean it's not true. Maybe there is an issue and she's having a hard time stating it correctly always check it out. If you are not sure always contact your ombudsman hopefully they can help solve the issue.
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Those are lots of very good questions that should be asked of an AL.

I would add:
1) When you first walk in, take a big breath in through your nose, and evaluate whether you smell urine or cleanliness.
2) observe how other residents are treated while you are there in person.
3) if you can, try to show up unexpectedly and observe any daily goings-on.
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Reply to PianoRobin
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Great questions below.
Get everything in writing.
Get copies of EVERYTHING you sign.
Meals: Costs Visitor/Guest Costs
What are their legal responsibilities should another level of care be needed and not available at your facility?

Read contract(s) carefully.
When do they notify you/family member (when alerted to medical or otherwise, need)

What is procedure if a person falls? (Most will not move/lift a resident. They call 911).

What is the staff ratio - how often do they check in on resident (if at all):
- Day time
- Socializing / events
- Night / sleep time

How often have your fees been increased over the last 10 years, i.e., is it yearly? What is the percentage of raising fees?

Get a list of 'extra' service fee costs 'add ons' - (i.e., help getting dressed in a.m., help getting undressed in p.m.

Do they assist with accidents (changing) ?

What services do they NOT offer that would / might require us (resident/family) to hire a caregiver? (From my experience working in this field, most/some residents in AL do employ caregivers).

Gena / Touch Matters
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Will fees be raised for services and if so when and how much time in advanced will we be notified of any increases?

Are nutritious meals and snacks served and/or are there access to healthy foods?

How does your discharge planning operate?
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