A System for Selecting an Assisted Living Community

As you have likely learned through reading our blog posts and your own life experiences, the transition to assisted living is a stressful and emotionally charged period of your life. It’s also likely an incredibly scary and uneasy part of your loved one’s life.

In previous posts, we’ve shared information to help prepare you for this moment – the time when you and your loved one will select an assisted living community.

Visit our previous posts for resources on what to look for when researching and touring assisted living facilities. This information can help to convert a chaotic and often panic-filled situation into a calm, thoughtful and logical decision making process.

Now let’s discuss how to select the right assisted living community for your loved one:

Comparing the Finalists
By now you should have collected detailed information on several assisted living communities. You’ve had good and bad first impressions of communities, people, insurance companies and all the things that run hand-in-hand with this transition. For reasons both known and unknown to you, you’ve probably also excluded several communities.

When trying to find a community for my mom, my sister and I looked at many communities before ultimately making a decision. We struggled to find a technique that enabled us to make a decision that satisfied three criteria:

1. Compare all communities across the same attributes

2. Give some attributes more weight than others

3. Deliver an objective, measurable final selection

Why were we so formal? Because we knew that we had put every ounce of our souls into finding the best community we could. We didn’t want to ruin a decision by injecting too much bias into it..

Choosing Attributes

We decided on six attributes on which to make our community selection. They are:

  • Location: the geographic location of the community; proximity to family, friends and shopping; amenities of the community and size/ layout of the apartment.
  • Staff: experience of the executive team; friendliness of the dining room staff; staff treatment of residents and their observed interactions.
  • Activities: activities calendar; personality and demeanor of the activities director; amenities related to activities including transportation, game rooms and other entertainment.
  • Quality of care: the experience of the nursing staff; proximity to fire, hospital and emergency services; rehabilitation rooms and quality of the therapists.
  • Cost: total monthly cost of community at the level of care required for my mother.
  • Gut feeling: you have instincts for a reason. Use them.

Over the last several years, I’ve shared this list with many people and validated that it addressed the vast majority of families. Now that you have a group of attributes against which you can measure your finalists, let’s add a measure of importance to each one.

Weighing Attributes
Different things are important to different people, and you’ll likely have strong feelings about the relative important of one attribute over another. This is called weighting.

Weights are applied by giving each attribute a percentage from 0-100%. Those attributes you deem most important receive the highest percentage weight. The total of all attributes must equal 100%.
It’s important that you apply weights to the attributes before you begin ranking your community finalists. This will enable you to minimize unnecessary bias before the score process.

Ranking Final Communities
Now that you have removed the unnecessary bias from your decision, you can score each community against the others. The score will occur for each attribute above. You will likely find communities will be a leader in some attributes and a follower in others. This is normal.

Armed with this system, you will be able to sift through all of the information you’ve gathered and decide on a community that will meet your loved one’s and your family’s needs.

Photo credit: winnifredxoxo

  • Anonymous

    Be careful – ALFs have become like nursing homes with a lot of sick people.Find out if there’s licensed nurse onsite 24/7 or just “on call.” Having a nurse onsite on all shifts is a must. Are activities planned for evenings/wwekends? Many facilities “appear” to have activities at these times but the activity person usually leaves at the end of the day so who is conducting them? Observe a meal and note if there is additional staff to help accommodate the increased physical needs assisted living residents sometimes require. Mealtimes are the best time to visit/tour so you can see the overall condition of residents and if your loved one is appropriate. Best tip of all – privately ask other family members, most of whom will tell it like it is! Most ALFs have a move-in fee ranging  from $500 to $1,000; usually not refundable. Used mainly to pay the salesperson’s bonus. Depending on census, this fee is negotiable and may be reduced/waived. Times are tough for these places and a bed in the head is worth more than a bonus for the salesperson. Be sure to negotiate this with the director, not the salesperson.

  • http://www.ryanmalone.com Ryan Malone

    Great comments -

    I actually wrote a chapter and how to get through the salesrep fluff. Worth the read if you are consider moving into assisted living.

  • Kim

    I work in assisted living and SO TAKE offense that the move-in fee pays a salesperson’s bonus.  I do not receive bonuses, I am strictly salary.  Most of my friends who do what I do don’t get bonuses either.  And most places, at least here in Minnesota, do not have an lpn on 24/7.  It would make costs prohibitive for families.  We do have home health assistants on 24/7.  Our RN’s are here Mon-Fri (except holidays) and are on call nights and weekends.  We’ve been in business 13+ years and it’s worked for us and for our families.  We’ve received numerous awards and are proud of the care we provide.

  • http://www.ryanmalone.com Ryan Malone


    Not speaking for livedwell, but I am glad you are working above board. I don’t think those fees pay a bonus. I do encourage families to talk to the EDs and other members of the management team so they can ask tough questions. Working solely with the sales and marketing team often shows a very glossy view of the community. I’ve found that if you ask tough questions – interview-type questions – of the staff members who aren’t accustomed to getting them, you can learn a lot.
    That’s just my approached. But it lets the good communities stand out why makes it crystal clear who are not focused on quality.

  • Kim

    We’re on the same wave length!   I encouage people who visit to speak with any of our staff or family members.  I also let people know, if it’s the first time they visit, even if they want to rent immediately, to go home and think about it for a day.  Moving is a big decision and it’s one I want them to feel confident with.  As a daughter with aging parents myself, if a sales person wanted them to “sign on the dotted line” after the first tour, I’d tell them not to go back to that place.  It’s a process, and while it can be encouraged…should never be rushed.  Thanks for your insight into the industry.  I believe most of us want what is best for seniors and their families.

  • Brian from medigapgroup.com

    Thank you so much for sharing. I haven’t quite gotten to the point of researching facilities yet, but I will in the near future. I’m currently living with my 92 year old grandfather, and soon it will be time for him to need more attention that I can possibly give him. It’s going to be hard but I know that it will eb what is best for him! And that is the most important thing. I know that many of these places are beautiful and absolutely perfect for what he needs and it’ll be something that he’ll really enjoy, but it will take us some time to get to that point!

    I also work with senior citizens every day, helping them cover the out of pocket gaps brought on by government Medicare. I know that they will appreciate this type of information greatly! Thanks again for sharing. You have an excellent blog.