How to Choose Assisted Living

How to Choose Assisted Living

Assisted living facilities and personal care boarding homes are referred to as assisted living residences. There are three types of assisted living residences: private pay, alternative care facilities (assisted living residences that are Medicaid certified) and residential treatment facilities for persons with severe and persistent mental illness. Any assisted living residence caring for 3 or more residents must be licensed.

Private pay assisted living residences are licensed. Alternative care facilities have Medicaid clients, and are licensed and certified. Residential treatment facilities are mental health facilities and are licensed. They are operated by the local mental health center.

Assisted living residences range in size from 3 to 274 beds. The most common reasons for admission to assisted living residences are medication management, bathing and dressing assistance, and the need for protective oversight and supervision.

Assisted living residences provide a range of services including room, board and at least the following: personal services, protective oversight, social care and regular supervision available on a 24-hour basis.

Personal services include a physically safe environment, supervision, assistance with activities of daily living such as medication administration, bathing, dressing, eating, laundry, recreational activities and arrangements for transportation. Protective oversight includes monitoring the needs to ensure the residents receive the services and care necessary to protect their health, safety and well-being.

The Health Facilities and Emergency Medical Services Division ensures that assisted living residences meet established standards for health and safety which include resident rights, protection from abuse, quality of residents’ lives and quality of residents’ care through unannounced annual surveys and complaint inspections.

How to Choose an Assisted Living Facility

The following tips assist consumers in choosing the most appropriate assisted living facility for themselves or their loved ones. Remember to use all five senses when visiting and making your selection. Trust your initial feelings and reactions. The following questions are meant to assist you in your decision making process.

Provider Agreement and Policies:

* Do the admission criteria match my needs?
* Have I reviewed the terms of the financial/provider agreement?
* Is the unused portion of the rent refunded upon transfer/discharge?
* Do I have a choice in the selection of medical/health care providers if additional services are needed?
* Are the specific services offered clearly identified in the agreement?
* Have I reviewed the house rules?
* Have I reviewed all of the reasons for which I may be transferred of discharged?

License and Certification:

* Is the facility licensed by the state and in good standing?
* Is the facility Medicaid certified?


* Is the bedroom private or shared?
* Is the bathroom private or shared?
* Are the shared areas clean?
* Is there space for personal belongings?
* Does the floor plan allow for easy mobility for me?
* Are there private areas other than the bedroom for visits?


* Is bathroom safety equipment installed or available if needed? (grab bars, raised toilet seat)
* Is there a call system?
* Are walkers/wheelchairs permitted?
* Are hallways and doorways wide enough for wheelchairs?

Care Plans:

* Am I involved in the care planning process?
* Is my family/responsible party involved?
* Is my physician or other health provider involved?
* Are the care plans updated to reflect changes in care needs?

Personal Services:

Does the facility provide:

* Assistance with dressing?
* Assistance with bathing?
* How many times per weeks is bathing provided?
* Assistance with toileting?
* Assistance with incontinency? Does this include assistance with bowel and bladder?
* Assistance with transfers from wheelchair to bed, etc.
* Assistance with medications?


* What is the operator/administrator’s training?
* Do staff receive training to work with special needs or behaviors, such as dementia?
* Is there high staff turn-over?
* What is the ratio of staff to resident?
* Are staff awake at night?


* Are specialized diets available?
* Are cultural or ethnic preferences considered?
* Are residents involved in menu planning?
* Can residents help with meal preparation and have access to the kitchen?
* Are snacks/beverages readily available between meals?
* Are extra helpings and substitutions available?


* Are activities available within the facility?
* Does the facility take residents on outings?
* Is somebody designated to conduct activities?
* Would my interests match the level/type of activities provided?
* Are there residents I can socialize with?
* Is there a written schedule of activities?
* Does the facility provide transportation?


* Does facility inform family/physician when an unusual event occurs?
* Do you feel comfortable talking with the:
* Administrator/Operator
* Manager/Billing
* Staff/Caregivers
* Is the grievance procedure easily understood?
* Is telephone use accessible and conducive to privacy?

Facility Tour and Observations:

* Have I toured the entire facility?
* Have I observed the kitchen and pantry?
* Have I observed a meal?
* Does the atmosphere seem pleasant?
* Does there seem to be enough staff available?
* Are pets allowed?
* Do residents seem happy and engaged?
* Do residents appear to be clean, groomed and odor-free?
* Have I observed for staff/resident interaction?
* Have I observed for cleanliness and odors?

Additional Resources:

Your State Ombudsman Program: Serves as advocate for residents and families

Your State’s Health Department

To review …

We realize that making the decision to place a loved one in a care facility can be difficult. When making your final selection keep these tips in mind:

* Trust your initial feelings and reactions.
* Try not to make a hasty decision. There are many homes from which to choose.
* Consider the location of the home. Your presence and involvement in the facility is important to the care your loved one receive.
* Make an unannounced visit after your initial tour.
* Talk to residents.
* Ask for references.
* Ask to take home copies of the admission packet and house rules.
* Take the time to review the materials and, ask lots of questions.

Source: Colorado Department of Public, Health & Environmental Health Facilities Division,
Provided by: The Staff at
For more information: Visit your state’s Department of Public Health

Copyright © 2008 All rights reserved.

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