Free Resource · 2026 Edition
The Senior Living Report
Facility Evaluation Checklist
What to look for — and what to ask — before you commit to any senior living facility
Why This Checklist Exists
In my years as a nurse, I have watched families make one of the most consequential decisions of their lives — choosing a senior living facility — in a matter of days, sometimes hours, under enormous emotional pressure. They tour a beautiful lobby, meet a friendly admissions coordinator, and sign paperwork before they have asked a single hard question.
This checklist is what I give every family before they set foot in a facility. It is not meant to scare you. It is meant to slow you down just enough to make a decision you can stand behind.
Print it. Bring it on every tour. Do not commit to any facility until you have walked through this with your own eyes and your own questions.
“Do not commit to a facility until you have toured multiple options. The right place will welcome your questions — and give you straight answers.”
Your Evaluation Tool
What to Observe, Ask, and Record
01
Staffing & Care Ratios
Staffing is the single most important factor in care quality. Beautiful facilities with inadequate staffing produce poor outcomes. Get specific numbers — not impressions.
What is the staff-to-resident ratio during the day, evening, and overnight shifts?
What is the staff turnover rate? High turnover is a red flag — it signals poor management and disrupts continuity of care.
Are staff members trained specifically in dementia care, fall prevention, or other relevant conditions?
Observe staff interactions with residents during your tour. Are they warm, patient, and respectful — or distracted and task-focused?
Who provides medical oversight? Is there a physician or nurse practitioner on site or on call 24/7?
02
Environment & Safety
You can assess this category with your own eyes. Walk slowly. Look beyond the lobby. Visit common areas, hallways, and if possible, a resident room.
Does the environment feel welcoming upon entering — not just decorated, but genuinely warm?
Are hallways and common areas clean, well-lit, and free of odors? Persistent odor is a sign of inadequate staffing or poor hygiene protocols.
Are fall prevention measures visible? Look for grab bars, non-slip flooring, adequate lighting, and call systems in bathrooms.
Is outdoor space accessible and safe for residents to use independently or with minimal assistance?
How does the facility handle emergencies? Ask about fire safety, evacuation plans, and after-hours medical response.
03
Care Planning & Communication
A good facility treats your family member as an individual, not a room number. The care plan process tells you everything about how they will be treated.
How are care plans developed? Is the resident and family included in the process?
How often are care plans reviewed and updated as needs change?
How does the facility communicate with family members? Who is your primary contact, and how quickly do they respond?
What is the process if a resident’s condition declines? Can they remain in place, or will they need to move?
04
Costs & Financial Transparency
Hidden fees are common. Get everything in writing before you sign. The base rate rarely covers everything your family member will actually need.
What is the base monthly rate, and exactly what does it include?
What services cost extra? Ask specifically about medication management, incontinence care, transportation, and therapy.
How often do rates increase, and by how much on average per year?
Does the contract disclose all fees attached to healthcare and supportive services?
What is the refund policy if your family member needs to leave or passes away?
05
Contract & Resident Rights
Before you sign anything, have someone read the contract who is not emotionally invested in the decision. Better yet, have an elder law attorney review it.
What are the conditions under which the facility can ask a resident to leave?
What grievance process exists for residents and families to raise concerns?
Ask to see the most recent state inspection report. Any facility licensed by the state is required to make this available.
Does the contract include an arbitration clause that limits your right to sue? This is worth noting before you sign.
After the Tour: Your Gut Check
Strong Fit
Staff were warm and forthcoming. Questions were welcomed. The environment felt lived-in and calm.
Needs More Info
Some answers were vague or deflected. Schedule a second visit at a different time of day.
Walk Away
Evasive answers, high turnover, poor hygiene, or pressure to sign quickly. Trust that instinct.
My rule: if they pressure you to decide before you are ready, that tells you everything you need to know about how they will treat your family member once they have their signature.
