Medical Alert Systems, Medical Affiliations,
and Levels of Care Questions

Medical
Tier I Questions (for early in the vetting process)

• Does each independent living unit have an alert system? Does it call on-site security or a nurse or both? Is it wireless and does it work with a mobile pendent?
• Does it work only on-site? Will it work if they are not in their apartment but walking on the campus? What if my parent calls 911?
• Do you have an affiliation with a local hospital, home health agency, or physicians’ group?
• Do you have any medical offices on-site? Any kind of wellness clinic? What are the hours of operation?
• Is there any kind of therapy center on-site offering physical therapy, occupational therapy, etc.?
• Is a nurse available 24/7 or is there a nurse’s office residents can go to during the day? What are the hours of operation? What about weekend emergencies?
• Do you have assisted living, memory care, rehabilitation care, and/ or nursing care on-site?
• Do residents have first access to any higher level of care or does the public? (Or do they hold available rooms for residents of the community before opening these to the public?)

Tier II Questions (for when you are narrowing down your choices/options)

• How are residents billed for general healthcare (seeing an on-site doctor of any kind or a nurse in a wellness clinic, for example)?
• Do you accept any kind of Medigap or supplemental insurance? Is it required? (Some life care communities do require it.) Note: Some rehab facilities will not accept any Medicare Advantage plan.
• Do you accept all long-term care insurance contracts in your higher levels of care?
• Is there a home health agency connected with your community or on-site for residents to hire if needed?
• Do you allow residents to hire their own private care?
• Does a podiatrist come to your community to see residents? Any other medical specialists? (Audiologists?)
• Do you provide transportation to medical appointments from assisted living or memory care? Wheelchair or mobility-impaired
transport?
• Can I hire a staff person to accompany my parent? Through you or an agency?
• How do you screen your employees?
• What are your staff-to-resident ratios? What are your state requirements?
• How do you staff for the 11 pm–7 am or night shift?
• What is your staff turnover?
• Will you share your survey results with me? Have you had any major citations or violations?

Additional Questions to Ask for Assisted Living,
Memory Care, and Skilled Care

If the community you are considering offers any kind of assisted living (AL), memory care (MC), or skilled nursing care (SN), these questions will apply.

Floorplans/Rooms

• What apartment floor plans are generally available? (For AL and MC only.)
• Are rooms private or semiprivate? (Some ALFs have shared rooms. For SNFs, this is an important question because the cost will be far greater for private rooms. Most SNFs are built on a shared room design, so private rooms are typically more difficult to find.)
• What is the cost? Is there any discount offered for residents of the
community? Are these discounts time limited (i.e., is there a set amount of days before fees return to market rate)?

Administrative

• Is any care included as part of the contract? (Note: Even some rental communities include a limited number of free days in assisted living, usually based on twelve months of continued residency.)
• Do you base your cost on levels of care needed or do you charge one all-inclusive fee? (For AL only.)
• Are your healthcare facilities open to the public? (For a life care community only.)
• Are residents given preference for placement before the public?
• Who is your medical director or healthcare administrator? (For AL or SN only.)
• Are there any types of medical conditions the facility cannot accept, and if so, which ones are they? (Note: Definitely true for ALFs.
Even some SNFs won’t accept very high-need patients.)
• How do you care for residents/patients with advanced dementia? Are they in a secure area?
• Do you work with a hospice organization?
• Do you have a designated hospice room or suite so families can stay as well?

Staffing

• Do you use outside staffing? How do you screen your employees?
• If my parent has to go to the hospital, do you hold their room in skilled care? For how long?
• Does your assisted-living area have a license for extended congregate care or any license allowing you to provide more care than just
the basic AL license?
• What are your staffing ratios? Does it change over the weekends?
• Is there a nurse on every shift?
• Do you have an evacuation plan for an emergency or for a natural disaster? May I see it? What agency has to approve this? Have you ever had to evacuate?
• What are your staffing levels in your healthcare area?

Memory Care

• Do you offer secure care or a designated memory care area for any residents who need this?
• What social and recreational activities do you offer in assisted living or memory care, or skilled care? May I see the calendar of activities?
• When was your last survey by your state oversight agency? May I see the results of your past several surveys?
• How did you handle Covid, and do you require all your staff to be vaccinated? Your residents?