How to Use This Checklist
Tour your top 2–3 facilities (found with our free search tool), bring this list, and take notes on each answer. You won't get through all 50 questions on one visit — the bolded sections (staffing and costs) matter most. Afterward, put your finalists side by side with our comparison tool to check their official quality data against what you saw.
Table of Contents
Before You Tour: 15 Minutes of Homework
- ✓Look up the facility's quality scores and CMS star ratings — especially the health inspection rating — in our search tool.
- ✓Skim the most recent inspection report so you can ask about specific citations (our inspection report guide shows you how in plain English).
- ✓Write down your loved one's non-negotiables: medical needs, dietary needs, language, religious practice.
- ✓Schedule the tour for late morning through lunch, so you can see a meal served — and plan an unannounced second visit on an evening or weekend.
Staffing Questions (1–10)
Staffing is the single best predictor of day-to-day care quality. Note that as of mid-2026 there is no federal minimum staffing mandate (the 2024 rule was rescinded), so facility-by-facility differences are large — and worth probing hard:
- What is the resident-to-aide ratio on the day shift? Evening? Overnight?
- Is a registered nurse (RN) physically on-site 24/7, or only on call at night?
- What was your staff turnover rate over the past year?
- How long have your administrator and director of nursing been here? (Frequent leadership churn is a warning sign.)
- How often do you use temporary agency staff?
- How do you cover call-outs, weekends, and holidays?
- What dementia-care training do aides receive, and how often?
- Can I meet the nurse and aides who would care for my loved one?
- How quickly are call lights answered, and do you track it?
- Who is my single point of contact when I have a concern, and how fast do they respond?
Medical Care Questions (11–18)
- How often does a physician or nurse practitioner actually see each resident?
- Can my loved one keep their current doctor and specialists?
- How do you handle medical emergencies, and which hospital do you transfer to?
- How are medications managed, reviewed, and double-checked for errors?
- What therapy services (physical, occupational, speech) are provided on-site, and how often?
- What is your approach to preventing pressure ulcers and treating wounds?
- What is your fall-prevention program, and what happens after a fall?
- How — and how quickly — do you notify family of a change in condition?
Safety & Cleanliness Questions (19–25)
- May I see your most recent health inspection results? (They must make these available on-site.)
- What were your most recent deficiencies, and what specifically changed afterward?
- How is the building secured, and how do you protect residents who wander?
- What is your infection-control protocol when illness spreads through the facility?
- How often are resident rooms and bathrooms cleaned?
- How is personal laundry handled, and how do you prevent lost belongings?
- What is your emergency plan for fire, power loss, or severe weather — and when was the last drill?
Food & Dining Questions (26–32)
- May I see this week's menu — and may we taste a meal during the tour?
- How do you handle special diets (diabetic, pureed, low-sodium, religious, cultural)?
- Can residents choose an alternative if they don't like what's served?
- What are the mealtimes, and can residents eat in their rooms when they prefer?
- How do you assist residents who need help eating — and how many staff are in the dining room at meals?
- Are snacks and drinks freely available between meals?
- How do you monitor for weight loss and dehydration?
Activities & Quality of Life Questions (33–40)
- May I see this month's activity calendar? (Check it against what's actually happening as you walk.)
- What activities run on evenings and weekends, not just weekday mornings?
- How do you engage residents with dementia or limited mobility?
- Is there safe outdoor space, and how often do residents actually go outside?
- Can residents personalize their rooms with furniture, photos, and belongings?
- What are the visiting policies? Any restrictions on hours or children visiting?
- Is there an active resident council and a family council I could speak with?
- How do you support religious and spiritual practices?
Costs & Contract Questions (41–50)
Get every answer in this section in writing. With national median costs around $9,581/month for a semi-private room (CareScout 2025 Cost of Care Survey), surprises here are expensive:
- What is the daily or monthly rate, and exactly what does it include?
- What services cost extra, and what are their prices? (Ask for the written fee schedule.)
- Do you accept Medicare? Medicaid? Both?
- If my loved one spends down to Medicaid later, can they stay in the same bed?
- What deposit or entrance fee is required, and is it refundable?
- How are "level of care" charges determined, and how much notice do you give before rate increases?
- What is your bed-hold policy if my loved one is hospitalized?
- Under what circumstances can a resident be involuntarily discharged or transferred?
- Does the contract ask a family member to be personally responsible for the bill? (Be very careful with "responsible party" clauses — consider legal review before signing one.)
- Can I take the contract home and review it before signing? (The only acceptable answer is yes.)
Unsure how Medicare, Medicaid, and other sources fit together? Our coverage guide and 2026 cost guide walk through the numbers.
What to Observe (Beyond the Questions)
Answers can be rehearsed; the building can't be. While you walk, pay attention to:
👃 Smell & sight
- • Persistent urine or feces odor = hygiene and staffing problems. (Heavy air freshener everywhere can be a cover-up.)
- • Are residents clean, groomed, dressed, and out of bed?
- • Are hallways clear, well-lit, with working handrails?
- • Look at lunch trays: does the food look like something you'd eat?
👂 Staff interactions
- • Do staff greet residents by name and knock before entering rooms?
- • How long do call lights blink before someone responds?
- • Do staff talk to residents or over them?
- • Watch a transfer or wheelchair assist: gentle and unhurried, or rough and rushed?
🕐 Timing tricks
- • Make your second visit unannounced, on an evening or weekend, when staffing is thinnest.
- • Arrive 15 minutes early for the scheduled tour and watch the lobby.
- • Sit near the dining room at mealtime: it's the truest picture of staffing and resident life.
💬 Talk to people
- • Ask a visiting family member in the parking lot: "Would you place your loved one here again?"
- • Chat with an alert resident: "How's the food? Do they come when you call?"
- • Note whether staff seem comfortable letting you talk to residents — or steer you away.
Scoring tip: After each tour, rate the facility 1–5 on staffing, cleanliness, food, resident engagement, and cost transparency while it's fresh. Numbers written in the parking lot beat impressions recalled a week later — and make comparing facilities far easier.
Build Your Tour List First
Don't tour blind — search facilities near you, check inspection-based quality scores, and pick your top 3 before you ever get in the car.
Related Guides
Note: This checklist provides general guidance, not medical or legal advice. Contract terms vary widely — consider having an elder law attorney review any admission agreement, especially one with personal-liability clauses, before signing.