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The best providers enjoy answering hard questions; evasive answers are themselves an answer. Use the four sections below to cover staffing, safety, cost, and daily life, and jot notes as you go so the communities don’t blur together afterward.
1. What is the caregiver-to-resident ratio during the day, in the evening, and overnight and is the overnight caregiver awake?
2. How long have your current caregivers worked here? What is your annual staff turnover?
3. What training do caregivers complete, including dementia-specific training, and how often is it refreshed?
4. Who assesses my parent’s care needs, and how often is the care plan reviewed with the family?
5. Who is the delegating nurse, and how often do they see each resident?
6. How do you handle a resident whose needs increase at what point could they be asked to leave?
7. May I speak with two current families as references?
8. How are medications stored, administered, and documented and by whom?
9. What happens when a resident falls? Walk me through the last fall in this home and how the family was told.
10. Which physicians, podiatrists, or labs visit the home? How do residents get to outside appointments?
11. How do you coordinate with hospice if it becomes needed?
12. May I see your current Maryland OHCQ license and most recent inspection report?
13. What are your infection-control and emergency-evacuation procedures?
14. What is the all-in monthly rate for my parent’s current needs including every fee, in writing?
15. What exactly triggers a rate increase, and how much notice do you give?
16. Is there a community fee, deposit, or assessment fee? Is any of it refundable?
17. What happens financially if my parents are hospitalized for two weeks? If funds run out?
18. Do you accept long-term care insurance, the Maryland Community Options waiver, or VA Aid & Attendance?
19. What are the discharge/termination clauses for both sides and the notice period?
20. What did residents eat yesterday? Who cooks, and how are dietary needs handled?
21. What does a typical Tuesday look like, hour by hour?
22. How are activities chosen and what happens for a resident who doesn’t want group activities?
23. What is your visiting policy? Can family join meals?
24. How do you help a new resident settle in during the first two weeks?
25. Why do families choose you over the community down the road and who is NOT a good fit for your home?
Look at the people and the details: how staff interact with residents, whether caregivers seem rushed, cleanliness, meal quality, and the mood in common areas. Beyond the tour, confirm the caregiver-to-resident ratio, staff training and turnover, the all-in cost in writing, the current OHCQ license, and how the community handles rising care needs and emergencies.
Warning signs include vague answers about cost or refusal to put the full rate in writing, high staff turnover, an unwillingness to show the current Maryland OHCQ license and inspection report, no clear plan for falls or increasing care needs, unpleasant odors, and tours that skip common areas at mealtime. Evasiveness itself is a red flag.
Most families find touring three to five communities gives a useful basis for comparison without becoming overwhelming. Include at least one small residential home and one larger community so you can feel the difference. Bring the same 25 questions to each so you’re comparing them fairly, and take notes right after each visit.
Ask for the all-in monthly rate for your parent’s current needs, in writing, and exactly what triggers an increase and how much notice you’ll get. Ask about community fees, deposits, or assessment fees and whether any are refundable, what happens financially during a hospital stay or if funds run low, and which benefits or insurance the community accepts.
