CareGrade™ OriginalQuick Answer
Before choosing a senior living community, families should ask 20 critical questions covering care quality, staffing, regulatory compliance, pricing transparency, and family communication. Use the SeniorTrust™ Score from CareGrade™ to answer many of these with verifiable data before you even schedule a tour.
Why a Checklist Matters
When you tour a senior living community, you're seeing a carefully curated experience. The staff knows you're coming, the common areas are clean, and the marketing representative has rehearsed answers.
A structured comparison checklist ensures you collect the information that actually matters — not just what the community wants you to see.
The 20-Question Senior Living Comparison Checklist
Care Quality & Safety (Questions 1–5)
1. What were the results of your last regulatory inspection?
Ask to see the actual inspection report. If the community hesitates, that's a red flag. CareGrade™ links to every community's inspection data.
2. Have you received any Type A deficiencies in the past 3 years?
For RCFEs, Type A deficiencies indicate immediate jeopardy. Zero across multiple cycles is the gold standard.
3. Do you have an abuse icon or substantiated abuse citations?
For SNFs, CMS assigns an abuse icon for substantiated abuse. If yes, ask about corrective actions.
4. What is your fall rate and how do you compare to the national average?
A community that tracks fall rates is demonstrating accountability. One that doesn't is a red flag.
5. How do you manage medication, and what error rate do you experience?
Ask about electronic vs. paper systems, who administers medications, and error rates.
Staffing (Questions 6–10)
6. How many RN hours per resident per day do you provide?
National average is ~0.5 hours. Above 0.7 is excellent. Zero on weekends is concerning.
7. What is your staff turnover rate, particularly for RNs and administrators?
High turnover (above 50% for RNs) signals instability. CMS publishes this for SNFs.
8. What is your staff-to-resident ratio on day, evening, and night shifts?
Ratios should be higher during waking hours. Ask about overnight staffing — some have only one awake staff member for 30+ residents.
9. Do you have a full-time Registered Nurse on staff?
Many RCFEs don't. For complex medication regimens, an on-site RN matters. Memory care staff should have specialized dementia training.
10. How do you handle staff call-outs and shortages?
Do they use agency staff? Do they have a backup pool? Do they reduce services during shortages?
Pricing & Financial Transparency (Questions 11–14)
11. What is the actual monthly cost, including all required fees and add-ons?
Ask for a complete fee schedule: base rate, care level add-ons, medication fees, incontinence supplies, community fees.
12. How often do rates increase, and what was the average increase over the past 3 years?
Most raise rates annually. A community raising 8%+ annually is significantly more expensive over a 5-year stay.
13. What happens if my loved one's care needs increase? Will they be discharged?
Critical question. Many AL communities discharge residents whose needs exceed capabilities. Ask what level requires discharge.
14. Is your pricing verified and publicly available?
CareGrade™ verifies pricing from multiple sources. If pricing requires a "consultation" to reveal, ask why.
Environment & Engagement (Questions 15–17)
15. What is your activity calendar, and how do you ensure residents actually participate?
Ask how they track engagement and what percentage participate. A printed calendar means nothing without participation.
16. How is your memory care environment designed for safety and dignity?
Look for: secured perimeters, circular hallways, memory boxes, contrast colors, secured outdoor spaces.
17. What is your dining program like, and can you accommodate special diets?
Ask to see a weekly menu. Look for fresh ingredients, variety, and therapeutic diet accommodations.
Family Communication & Transparency (Questions 18–20)
18. How do you communicate with families about care changes and incidents?
Look for: regular care plan meetings, incident notification protocols, and a designated family liaison.
19. Can I see your latest inspection report and complaint history?
The ultimate transparency test. A community that readily provides inspection reports demonstrates accountability.
20. What is your SeniorTrust™ Score, and can you explain the category breakdown?
A community aware of its score and able to discuss strengths and areas for improvement is engaged with quality.
How to Use This Checklist With CareGrade™
- Check the SeniorTrust™ Score — answers questions 1–3, 6–7, and 19
- Read the score breakdown — understand which categories drove the score
- Review the inspection history — linked from every community page
- Check pricing transparency — verified with confidence scores
- Compare 3–4 communities using CompareWHY™ before touring
- Bring this checklist to each tour and document in CareCircle™
After the Tour: Evaluating Your Notes
After touring 2–3 communities, compare:
- Which had the strongest regulatory record?
- Which had the best staffing data?
- Which was most transparent about pricing and policies?
- Which felt like the best cultural fit?
- Which had the fewest red flags?
If a community feels warm but has a poor SeniorTrust™ Score, trust the data — tours are curated. If a community has an excellent score but feels wrong culturally, keep looking.
Frequently Asked Questions
Should I trust my gut feeling from a tour?
Tours are valuable for cultural fit and the "feel" of a community. But they should never override regulatory data. Always check the SeniorTrust™ Score first.
How many communities should I tour?
After narrowing to 3–4 with strong trust scores, tour 2–3. More than 4 leads to decision fatigue.
What if the community refuses to answer some questions?
Transparency is non-negotiable. A community that won't answer questions about inspections, staffing, or pricing is telling you something important.
Can I use this checklist for CCRCs too?
Yes, plus additional questions about contract types, entrance fee refundability, and what happens if the resident outlives their financial resources.