Questions to Ask on a Tour

• What is your staff-to-resident ratio during the day? In the evening? Overnight?
• Do residents have consistent caregivers, or does staff rotate frequently?
• What is your staff turnover rate? How does that compare to industry average?
• How do you handle staffing when someone calls in sick?
• Are agency or temporary staff ever used? How often?
• How long has the community director been in this role?

What to listen for: specific numbers, not general reassurances. "We always have enough staff" is not an answer. A ratio of 1:6 during the day and 1:12 overnight is an answer.

• What dementia-specific training do caregivers receive before working with residents?
• How many hours of training per year are required?
• How are staff trained to handle agitation, sundowning, or exit-seeking behavior?
• Is there a nurse or licensed clinical staff member on site at all times?
• What is your policy for calling families when a resident's condition changes?

What to listen for: specific training programs and hours, not just the word "trained." Ask what the training actually covers.

• How are exits secured? What prevents a resident from leaving unsafely?
• What happens if a resident attempts to elope or becomes agitated near an exit?
• Have you ever had a resident elope? How was it handled?
• Are outdoor spaces enclosed so residents can go outside independently?
• How are residents monitored overnight?

• How are medications managed and administered?
• Who oversees medication management — a nurse or a caregiver?
• How do you handle a resident who refuses medication?
• Do you have a relationship with a physician or geriatrician who visits regularly?
• How do you handle a medical emergency in the middle of the night?
• Under what circumstances would a resident need to be transferred to a hospital?

• At what point would my loved one need to leave this community?
• What behaviors or medical needs exceed what you can safely manage?
• How do you handle residents who develop hospice needs? Can they stay here?
• How often is care level reassessed? Who conducts that assessment?
• What happens to the monthly rate when care needs increase?

This last question matters a great deal financially. Care level increases often trigger fee increases of $500 to $1,500 per month. Ask how that process works and how much notice families receive.

• Can you walk me through a typical day for a resident?
• What does the activity calendar look like? Can I see a recent one?
• How do you adapt activities for residents who can no longer participate in groups?
• What happens on weekends — is programming different?
• How do you handle residents who prefer to stay in their rooms?
• How is mealtimes structured? Can residents eat at different times if needed?

• Can I see the menu for this week?
• How do you accommodate dietary restrictions or preferences?
• What happens if a resident stops eating well or loses significant weight?
• Who monitors nutritional intake and reports concerns?
• Can family members join for a meal? Is there a guest fee?

• What are visiting hours? Are there any restrictions?
• How do you communicate with families about day-to-day changes?
• Is there a family council or regular family meetings?
• What is the best way to raise a concern or complaint?
• Can family members bring personal items, decorate the room, or bring a pet to visit?

Open visiting policies and active family communication are good signs. Restricted visiting hours without a clear clinical reason warrant follow-up questions.

• What is included in the base monthly rate?
• What services are charged separately?
• What has your annual rate increase been over the last three years?
• Is there a community fee or move-in fee? Is any portion refundable?
• What is your policy on rate increases when care level changes?
• Do you accept Medicaid? Under what conditions?
• If a resident transitions to Medicaid, can they stay in the same room?
• What happens if a resident runs out of funds and does not qualify for Medicaid?