How to Evaluate a Memory Care or Assisted Living Facility

A tour of an assisted living or memory care community is a sales presentation. The lobby is beautiful, the admissions director is warm, and the brochure is full of promises. None of that tells you whether the care is good. These questions do.

Before the Tour: Do Your Research

Look up the inspection record. Every licensed care facility is inspected by the state. CMS’s Care Compare tool at medicare.gov/care-compare provides inspection reports, deficiency citations, and complaint history for Medicare and Medicaid-certified facilities. Check it before scheduling a tour.

Look for patterns, not just incidents. A single deficiency citation may not be concerning. Repeated citations for the same issues — medication errors, fall prevention, understaffing — are a pattern worth taking seriously.

Search for news coverage. A quick search of the facility name plus “abuse,” “neglect,” or “lawsuit” surfaces public record incidents that don’t always appear in state inspection databases.

Questions About Staffing: The Most Important Category

Staffing quality and continuity are the single best predictor of care quality — more predictive than the physical environment, the amenities, or the price.

What is the caregiver-to-resident ratio on day shift? Evening shift? Night shift? Memory care should have a significantly higher ratio than general assisted living. Ask for the actual numbers, not a vague description.

What is your annual staff turnover rate? High turnover is a red flag. Dementia residents depend on familiar faces and consistent routines. Frequent staff changes cause disorientation and distress. Industry average turnover is high — a community that has significantly lower turnover is doing something right.

What specific dementia training is required? How many hours? What topics? How often is it renewed? Is there ongoing training as dementia research evolves?

How is overnight staffing handled? This is where staffing is most often reduced. Dementia-related wandering and behavioral disturbance often peaks at night. Know exactly who is on overnight and what their response protocols are.

Questions About Safety

How is the community secured to prevent elopement? Secured entries and exits are the minimum. Ask specifically: what happens when a resident tries to leave? What are the physical barriers, the alarm systems, the protocols?

What are your fall prevention protocols? Falls are preventable with the right assessment and environment. Ask how residents are assessed for fall risk and what specific interventions are in place.

When was the last state inspection and were there any deficiencies? Ask directly and compare to what you found in the public record. A community that is evasive about their inspection history is a community worth being cautious about.

What is your family notification policy for incidents? You should be notified promptly when a fall, behavioral incident, medical change, or injury occurs. Ask for their written notification policy.

Questions About Daily Life

What does a typical Tuesday look like for a resident? A real answer describes structured activities, social engagement, and purposeful programming. A vague answer (“we have activities every day”) suggests less structure than may be needed.

How do staff handle a resident who is agitated or resistant to care? The answer should describe person-centered approaches: redirection, music, familiar routines, individualized approaches. Be cautious of answers that emphasize sedative medication as a first response.

What is your meals program? Nutrition matters significantly in dementia. Ask about the dining experience, how staff support residents who need assistance eating, and what happens when a resident refuses to eat.

What to Observe During the Visit

• Do residents appear cared for, clean, and engaged — or are they parked in front of a television?
• Do staff make eye contact with residents and speak to them with warmth?
• Is the environment calm or chaotic?
• Does the community smell clean?
• Do current residents look like your loved one could belong there?