What to Ask When Touring a Senior Living Facility

Choosing a senior living facility for a loved one is one of the most important — and often most stressful — decisions a family will ever make. Whether you are considering a personal care home, an assisted living community, or a skilled nursing facility, the tour is your single best opportunity to ask hard questions, observe daily life, and evaluate whether the facility is the right fit.

Many families feel overwhelmed during tours and leave without asking the questions that matter most. This guide is designed to change that. Below are the key questions you should ask on every tour — and, more importantly, why each question matters.

1. Is There a Bed Available Right Away — or Is There a Waiting List?

Why it matters: Availability is often the first practical hurdle a family faces. Some facilities have immediate openings; others have waiting lists that stretch weeks or months. Understanding the timeline is critical for care planning and can affect the urgency of your decision.

What to look for:

• Ask specifically whether availability differs between unit types (private vs. semi-private rooms).

  
  

• Inquire whether getting on a waitlist requires a deposit and whether that deposit is refundable.

  
  

• Ask how the facility notifies families when a bed becomes available and what the response window is.

  
  

• Understand whether there are different waitlists for different levels of care (e.g., memory care vs. general nursing).

  
  

• In Pennsylvania, skilled nursing facility admissions are often closely tied to Medicare and Medicaid certification — confirm the facility's current certification status.

2. What Is the Therapy Schedule, and Who Are the Therapists?

Why it matters: For residents recovering from a surgery, stroke, fall, or other medical event, therapy is often the primary reason for admission. The quality, frequency, and consistency of physical therapy (PT), occupational therapy (OT), and speech therapy (ST) can make a dramatic difference in a resident's recovery and long-term independence.

What to look for:

• Ask how many days per week therapy is provided, and whether therapy is available on weekends.

  
  

• Find out whether therapists are employed directly by the facility or contracted through an outside agency — in-house therapists typically offer more continuity.

  
  

• Ask how therapy goals are set and who is involved in that process — ideally the resident, family, and clinical team all participate.

  
  

• Inquire whether therapy services continue after Medicare coverage ends, and at what cost.

  
  

• Ask about the facility's outcomes: What percentage of residents return home after short-term rehab?

3. What Are the Opportunities for Family Meetings to Discuss Progress or Status?

Why it matters: Families are often the most important advocates a resident has. A facility that welcomes and structures family involvement will produce better outcomes and give you peace of mind. Understanding how — and how often — the clinical team communicates with families is essential.

What to look for:

• Ask whether care conferences or family meetings are held on a regular schedule (e.g., every 30, 60, or 90 days) or only when a problem arises.

  
  

• Find out who participates in care meetings — ideally you want the attending physician or director of nursing, social worker, and therapy team involved.

  
  

• Inquire about day-to-day communication: Is there a charge nurse or social worker you can call with questions? What is the typical response time?

  
  

• Ask whether family members can attend meetings virtually if they are not local.

  
  

• In Pennsylvania, residents in skilled nursing facilities have specific rights regarding care planning and family participation under both state and federal law — make sure the facility is aware of and responsive to those rights.

4. How Are the Units Divided — and Are There Special Units for Dementia or Memory Care?

Why it matters: Not all residents have the same needs. A facility that houses residents with a wide range of cognitive and physical conditions may not be the right fit for someone with Alzheimer's disease or another form of dementia. Specialized memory care units typically offer a structured, secure environment with staff specifically trained in dementia care.

What to look for:

• Ask how the facility separates residents by level of care or cognitive status, if at all.

  
  

• If a memory care unit exists, ask what makes it distinct: Is it physically secure? Do staff receive specialized dementia training? Is programming adapted for cognitive impairment?

  
  

• Find out what the staff-to-resident ratio is specifically on memory care units.

  
  

• Ask what the process is if a resident's condition changes — for example, if a general nursing resident develops dementia, can they transfer to a memory care unit within the same facility?

  
  

• Inquire whether the physical environment is designed with dementia in mind: clear signage, circular walking paths, reduced noise and confusion.

5. How Does a Resident Choose or Change a Doctor?

Why it matters: One of the most overlooked questions on facility tours concerns physician access. In many nursing homes, residents are assigned to a facility-affiliated physician and may have limited ability to keep their own doctor. Understanding how medical care is delivered — and by whom — is fundamental to informed decision-making.

What to look for:

• Ask whether residents may keep their primary care physician or must use a facility-affiliated doctor.

  
  

• Find out how often the attending physician visits the facility — some doctors see patients weekly, others much less frequently.

  
  

• Ask whether nurse practitioners or physician assistants are present more regularly, and what their scope of authority is.

  
  

• Inquire about after-hours and weekend coverage: who is responsible for medical decisions when the attending physician is unavailable?

  
  

• Ask about the process for specialist consultations — does the facility coordinate them, or is that the family's responsibility?

  
  

• In Pennsylvania, long-term care residents have the right to choose their own physician to the extent that the physician has privileges at or is willing to visit the facility.

6. How Does the Facility Categorize Residents on Nursing Home Units or Wings?

Why it matters: Within a skilled nursing facility, residents are typically grouped by care level, medical complexity, or other clinical factors. Understanding how residents are categorized — and what that means for your loved one's day-to-day experience — tells you a great deal about how the facility is managed.

What to look for:

• Ask whether the facility has distinct units for short-term rehabilitation versus long-term care.

  
  

• Inquire whether residents with complex medical needs (e.g., ventilator dependence, wound care, behavioral issues) are housed separately.

  
  

• Find out what criteria determine unit placement, and whether placement can change as a resident's condition evolves.

  
  

• Ask about the staffing model on each unit — higher-acuity units should have higher nurse-to-resident ratios.

  
  

• Observe the environment during your tour: Does the unit feel calm and well-managed? Are call lights being answered promptly? Are residents dressed and engaged?

Additional Questions Worth Asking

 

While the questions above should form the core of your tour, consider also asking:

• What is the facility's current staffing ratio, and how is overtime and agency staff usage managed?

  
  

• Has the facility received any state or federal citations in the past two years? (This information is publicly available through Medicare's Care Compare database.)

  
  

• What is the facility's policy on roommate assignments, and can residents request a room change?

  
  

• What activities and social programming are offered, and how frequently?

  
  

• What is the discharge planning process, and how does the facility support transitions home or to a lower level of care?

  
  

• What is the billing structure, and what is and is not covered under Medicare, Medicaid, or private pay?

A Note on Legal Considerations for Pennsylvania Families

Before your loved one is admitted to any senior living facility, you should ensure that important legal documents are in place, including:

•       A durable power of attorney for finances

•       A healthcare power of attorney or healthcare proxy designation

•       An advance healthcare directive or living will

•       A POLST (Physician Orders for Life-Sustaining Treatment) form, if appropriate

These documents ensure that the right person has the legal authority to make decisions on your loved one's behalf if they become unable to do so. Admission to a skilled nursing facility is not the time to discover that these documents have not been executed.

If your family needs assistance with elder law planning, reviewing admission agreements, or understanding your loved one's legal rights in a long-term care setting, consulting with a Pennsylvania attorney experienced in elder law and healthcare matters is strongly advisable.

Take Notes — and Bring Someone With You

Touring a senior living facility is emotionally and cognitively demanding. Bring a family member or trusted friend, take written notes, and do not hesitate to return for a second visit. Ask for copies of the facility's most recent state inspection report and the standard admission agreement so you can review them before signing anything.

The questions above will not just help you evaluate a single facility — they will give you a framework for comparing multiple options and ultimately making a decision that reflects your family's values, priorities, and your loved one's individual needs.