While certifications, accreditations, surveys, inspection reports and other recognized symbols of quality can be very informative, don’t underestimate the value of your own personal observations. Meeting staff, clients and current residents is a crucial component in the selection process. The following checklists include some important points to consider when making your decisions.

CHECKLIST FOR HOME- AND COMMUNITY-BASED SERVICES
Most services provided in your home do not have the benefit of a facility you can tour. However, there are still ways to gain a firsthand perspective. Pay attention to how staff members handle your inquiries. Ask to meet with the staff that will be providing the services in your home. And ask for a list of client references to contact. The following questions are some of the issues to consider.

Client Assessment
Ask the client references about their impressions of the staff. Do staff members listen respectfully to them and make eye contact? Do they greet clients by name? Are staff members appropriately dressed and polite? Are they prompt and reliable? Are they caring and capable?

Credentials and Quality Assurance
Does the agency or organization have applicable, current licensing? (Ask to see the most recent licensure report.) Is it Medicare or Medicaid certified? Are staff members credentialed and well trained? What is the staff turnover rate? Are there satisfaction surveys or other ways for clients and their families to provide feedback regarding the quality of care and other matters?

Financial Issues
What are the payment policies? Ask if there is a choice in payment plans and request a clear explanation of all options. Be sure you know all of the costs involved, what is included with each service, and how fees are billed. If you have concerns about how you will pay the fees, the care manager can assist you or direct you to the appropriate agency for assistance.

CHECKLIST FOR RESIDENTIAL OPTIONS
Visiting a senior residential community can reveal much more than a brochure or website can tell you. Be sure to schedule a tour and, if possible, visit the community or facility more than once, at different times of the day. The following list suggests some of the most important things to look for when you tour a retirement community. Remember it is not just a beautiful décor that counts, but the overall lifestyle.

Staff Attitude and Friendliness
Observe the staff interacting with residents and each other. Do they listen respectfully and make eye contact? Do they greet residents by name? Are staff members appropriately dressed and polite to each other? Do you feel welcomed while you tour? Are the directors willing and available to meet with you?

Residents’ Perspective
Talk with residents. Find out how much influence they have over their daily lives and the care they receive. How do they feel about living there? What do they like best about the community? Is there anything they don’t like?

Amenities and Services
Find out what services are included in the monthly fees and what services are extra. For example, are appliances included in maintenance/upkeep services? Is house cleaning, linen laundry or spring-cleaning included? Are there health and prevention services available? Ask to see all the amenities. Are they well maintained? Are the amenities and services that are important to you available on site?

Programs and Activities
Ask if the community has a staff member dedicated to planning services and programs for residents. If the community publishes a resident newsletter and/or events calendar, ask for sample copies. Check the calendar for small and large group activities, planned trips, spiritual opportunities, educational programs and activities that match your interests.

Dining
When you schedule a tour, arrange to have lunch or dinner while you are there, so you can evaluate the whole experience. Is the dining room clean and attractive? Is the staff courteous, efficient and welcoming? Is the food appetizingly prepared and tasty? Is there a diverse selection of entrées and side dishes? Do the dining hours and guest procedures fit your lifestyle?

Community Grounds
Are there accessible and safe areas on the campus or around the community for walking? Are the grounds landscaped and well maintained? Is there a courtyard, recreational areas or outdoor dining area? Are there areas for residents to garden? What types of outdoor activities are available?

Cleanliness and Maintenance
Look past the community's furnishings and into corners, baseboards and windows. Are the facilities clean, updated and in good repair?

Accessibility, Safety and Security
Are community amenities easily accessible to residents who use wheelchairs or other assistive devices? What other safety features are available throughout the community? Is there a system in place for a daily check on each resident? How is the community staffed? Who is on site to respond in the event of an emergency? How can residents contact staff if they have an emergency in their residence? What type of security is in place and how does it differ during off–hours?

Costs
Take the time to talk with an admissions representative. Review the admission policy and the residents’ bill of rights. Ask if there is a choice in financing plans, and a clear explanation of all options. If you have concerns about how you will pay the fees, the admissions counselor can assist you or direct you to the appropriate agency for assistance.

Trust Your Instincts
Does the community's appearance appeal to you? Did you feel at ease while touring? Do the residents seem like people you would enjoy getting to know? Does the community's level of formality or informality match your lifestyle? Does the community offer all the services and amenities that are important to you? Can you imagine yourself living there and being comfortable and happy?

ASSISTED LIVING AND SKILLED NURSING FACILITIES
In selecting a facility or community for assisted living or nursing care, nothing can provide a better perspective than visiting in person. Schedule a tour, and be sure to return for a second or third visit, at different times of the day. The following list suggests some of the most important things to look for.

Accessibility
Are community amenities easily accessible to residents who use wheelchairs or other assistive devices? Are apartment bathrooms accessible, with grab bars in convenient locations? What other safety features are available throughout the community?

Comfort and Enrichment
What are the choices in room accommodations? Do bedrooms have adequate privacy and plenty of room to move? What personal belongings may be brought into the facility? Does the facility have pets? Does the facility or community offer other services and amenities you need and want? Are there activity rooms and lounge areas for residents to use? Are the physical, intellectual, social and spiritual needs of residents being met? What religious activities are offered? Are special events held at the facility? Are special excursions planned for those able to take advantage of them? Do all residents have access to the outdoors? Do volunteers from the community assist with residents’ recreational activities? Is transportation to off-site appointments arranged and paid for by the provider?

Credentials and Quality Assurance
Does the facility have an applicable license? Ask to see the most recent licensure report. Is the facility or community Medicare or Medicaid certified? Are there satisfaction surveys or other ways for residents and their families or visitors to provide feedback regarding the quality of care and other matters? Is there an active residents’ council? Is there a family council? How are residents and their families involved in decisions that affect them? What are the policies on advance directives, "do not resuscitate" orders, physical restraints and chemical sedation?

Family and Friends
Will the location make it easy for family and friends to visit? What are the visiting provisions? Is there a private area for visits? Can family members have occasional meals with their relatives at the facility? Is there a private area for such meals?

Financial Issues
What are the payment policies? Take the time to talk with an admissions representative. Review the admission policy and the residents’ bill of rights. Ask if there is a choice in financing plans, and request a clear explanation of all options. If you have concerns about how you will pay the fees, an admissions counselor can assist you or direct you to the appropriate agency for assistance.

Health Services
What services are included in the daily or monthly rate? What services are available at an extra charge? What arrangements are there for residents to receive primary and preventive health services, including but not limited to annual physicals, immunizations and special screenings? If a resident is hospitalized, will the bed be held until he or she returns?

Safety and Security
Is the overall facility clean, odor-free, well-maintained, cheerful and safe? Are exits clearly marked and not locked on the inside? Do doors have alarm systems? What type of security is in place and how does it differ during off–hours? How does a resident contact staff if they have an emergency in their room or residence? How are medical emergencies handled?

Staffing
Do residents use their own physician, or is there an on-staff medical director? What is the ratio of staff to residents? Are there licensed nurses on staff or just nursing assistants? Who is on-site to respond in the event of an emergency? Does the staff seem friendly, caring and accommodating to residents and visitors? Do residents who need personal assistance appear to be clean, well-groomed and appropriately dressed?