Questions to Ask a Long Term Care Facility

What Questions Should You Ask a Long-Term Care Facility?

Choosing an assisted living community, nursing home, or memory care facility is one of the most important decisions a family will make. The brochures all look beautiful. The tours all highlight the best features. But how do you really know if a place will provide good care?

We worked with Lori Maloney, a long-term care expert and Umbra Health Advocate, to create a practical guide for evaluating facilities. This goes beyond the glossy marketing to help you understand what actually matters.

Before Your Visit: Do Your Homework

Before you even schedule a tour, gather some background information.

For nursing homes:

• Check Medicare Care Compare for quality ratings, inspection results, and staffing levels
• Look up recent inspection reports for violations or complaints
• Contact your state's long-term care ombudsman program for complaint history

For assisted living and memory care:

• Check your state's licensing website for inspection reports
• Look for online reviews, but take them with a grain of salt
• Ask people in your community for recommendations
• Contact your local Area Agency on Aging for referrals

This research helps you know what questions to ask and what to watch for during your visit.

Questions to Ask the Long-Term Care Facility

During your tour, the staff will tell you about the amenities and activities. But the questions below dig deeper into the quality of actual care.

About Staffing

1. What is the staff-to-resident ratio during the day? In the evening? Overnight?
2. Overnight is especially important. Some facilities have very few staff after 10 pm. Ask for specific numbers, not vague answers like "adequate."
3. What training do caregivers receive?
4. For memory care, ask specifically about dementia training. How many hours? What topics? Is it ongoing or just at hire?
5.  How long have most staff members worked here? High turnover is a red flag. Consistent caregivers who know the residents provide better care. Ask what percentage of staff has been there more than a year.
6. Is there a nurse on site 24/7? In assisted living, the answer may be no. Understand what happens if there is a medical issue in the middle of the night.

About Care Quality

1. How do you create and update care plans? Good facilities do a thorough assessment at move-in and update the plan regularly. Ask how often reassessments happen and how families are involved.
2. How do you handle medical emergencies? Which hospital do they use? Who makes the decision to call 911? How are families notified?
3. How do you manage behavioral challenges? This matters for any facility, not just memory care. Ask about their approach to agitation, resistance to care, or conflict between residents.
4. What happens when a resident's needs increase? At what point would they ask someone to move? How much notice do they give? Is there a higher level of care available within the same community?

About Costs

1. What is included in the base rate, and what costs extra? Get this in writing. Ask specifically about medication management, bathing assistance, incontinence supplies, and escorts to activities.
2. How do "levels of care" work, and what triggers a change?Understand the pricing tiers and what would cause your loved one to move to a more expensive level.
3. How much notice do you give for rate increases? Annual increases of 3 to 5 percent are common. But some facilities raise rates with little warning.
4. What is your discharge policy? Under what circumstances would they ask someone to leave? How much notice is required? Is any deposit refundable?

What to Observe During Your Visit

What you see and hear during your tour often tells you more than the answers to your questions. Pay attention to these details.

Watch the residents:

• •Do they appear clean, well-groomed, and appropriately dressed?
• Do they seem engaged or are they sitting alone staring at nothing?
• Are people participating in activities, or is everyone in front of a TV?
• Do residents interact with each other and with staff?

Watch the staff:

• Do they greet residents by name?
• Do they speak respectfully and make eye contact?
• Do they seem rushed, stressed, or indifferent?
• Do they knock before entering rooms?
• If you see a call light on, how long does it take for someone to respond?

"Time your visit so you can observe a meal. The dining room tells you a lot. Are people getting help who need it? Does the food look appetizing? Is it calm or chaotic?"

- Lori Maloney, Umbra Health Advocate

Look at the environment:

• Is the facility clean and free of strong odors?
• Are common areas bright, comfortable, and welcoming?
• Are hallways clear and safe for walking?
• Is the temperature comfortable?
• Do resident rooms look personalized, or are they bare and institutional?

Red Flags That Should Concern You

One concern might have an explanation. Multiple red flags should make you think twice. Pay attention if you notice:

Environmental Red Flags

• Strong, persistent odors of urine or feces
• Heavy air freshener that seems to be masking other smells
• Dirty common areas, bathrooms, or resident rooms
• Cluttered hallways or tripping hazards
• Broken equipment like wheelchairs or call bells

Resident Red Flags

• Residents who appear unkempt, unwashed, or wearing dirty clothes
• Unexplained bruises, cuts, or skin problems
• Residents who seem overly sedated or unresponsive
• People left sitting alone for long periods with no interaction
• Residents calling out for help with no staff responding

Staff Red Flags

• Staff who speak dismissively or disrespectfully to residents
• Long waits for call bells to be answered (more than 10 minutes)
• Staff who seem stressed, rushed, or overwhelmed
• Difficulty getting straight answers to your questions
• Management that is not visible or accessible

Business Practice Red Flags

• Pressure to sign a contract or put down a deposit immediately
• Unwillingness to let you visit unannounced or at mealtimes
• Reluctance to provide pricing information in writing
• Evasive answers about staffing levels or inspection results
• High staff turnover or recent leadership changes

Visit More Than Once

A single scheduled tour shows you the facility at its best. To get a fuller picture:

• Visit at different times of day (morning, afternoon, evening)
• Try to observe a meal
• Visit on a weekend when staffing may be different
• Ask if you can visit unannounced after your initial tour
• Talk to family members of current residents if you can

A facility that welcomes unannounced visits is usually more confident in its care quality than one that discourages them.

Questions to Ask Current Families

If you have the opportunity to speak with families of current residents, these questions can give you valuable insight:

• How responsive is the staff when you have concerns?
• Have there been any staffing changes or problems?
• Does the care match what was promised during the tour?
• What surprised you after your loved one moved in?
• Would you recommend this place to a friend?

Be respectful of their time and privacy, but most families are willing to share their honest experiences.

After Your Visit: Comparing Options

After visiting multiple facilities, it helps to compare them systematically. For each facility, note:

• Your overall impression (gut feeling matters)
• Specific things you liked and did not like
• Answers to your key questions
• Red flags you observed
• Total estimated monthly cost
• Availability and waitlist status

Trust your instincts. If something felt off during your visit, pay attention to that feeling. You are looking for a place where your loved one will be safe, comfortable, and treated with dignity.

What Good Care Looks Like

Beyond avoiding red flags, here is what quality long-term care actually looks like in practice:

• Residents are called by their preferred names and treated with respect
• Care is personalized, not one-size-fits-all
• Staff know the residents and their preferences
• Activities are engaging and matched to residents' abilities
• Families feel welcome and informed
• Problems are addressed promptly and honestly
• The environment feels calm, not chaotic
• Leadership is visible and accountable

"Good care is not about fancy amenities or beautiful buildings. It is about staff who have enough time and training to really care for each person. That is what you should be looking for."

- Lori Maloney, Umbra Health Advocate

Ongoing Monitoring After Move-In

Choosing a good facility is just the first step. Staying involved after your loved one moves in helps ensure quality care continues.

• Visit regularly and at different times
• Attend care plan meetings
• Get to know the staff by name
• Speak up promptly if you have concerns
• Watch for changes in your loved one's condition, mood, or appearance
• Know how to contact the state ombudsman if needed

Your ongoing presence and attention helps ensure your loved one receives the care they deserve.

Get Expert Help

Evaluating care facilities can be overwhelming, especially when you are already dealing with the stress of a loved one's declining health. You do not have to navigate this alone.

Umbra Health Advocacy can accompany you on facility tours, help you compare options, review contracts for hidden costs, and advocate for quality care. Our patient advocates know what questions to ask and what red flags to watch for.

Download our free Facility Visit Checklist: A printable guide you can bring on tours

Call us at 332-266-1738 or Tell us More.Get personalized help:

This article was developed in consultation with Lori Maloney, a long-term care expert and Umbra Health Advocate.