Twenty Questions to Ask When Touring an Adult Family Home

A license tells you an adult family home meets the state minimum. A tour tells you whether you would want your mother or father living there. The questions below are drawn from the DSHS consumer guide to choosing care, from placement checklists, and from the questions families actually ask us at Silvergate. Ask all of them. A good home will welcome every one.

Licensing and history

1. What is your DSHS license number, and may I see the license? It should be posted in the home. Look it up afterward on the DSHS locator.
2. When was your last inspection, and were there any citations? Inspection reports are public. A home that mentions a past citation and explains what changed is being straight with you.
3. Which specialty designations do you hold? If your parent has a dementia or mental illness diagnosis, the home must hold the matching designation to admit them.
4. Who owns the home, and do they plan to keep it? Adult family homes are sometimes sold, and a new owner can change everything.

The owner and the staff

1. Does the provider live here? If not, who is in charge day to day?
2. How many caregivers are on during the day, and how many at night? Is night staff awake? Ask for numbers, not reassurances.
3. What training do caregivers have, and how long have they worked here? Washington requires 75 hours of basic training and Home Care Aide certification. Low turnover is a strong signal.
4. Is there a nurse involved in care? How often, and who does nurse delegation? At Silvergate the owner is an RN; ask any home how nursing oversight actually happens.

Care capability

1. Can you show me your Disclosure of Services? Then compare it with what you were told.
2. Can you handle a Hoyer lift, insulin, two-person transfers, incontinence, hospice? Ask about the specific needs your parent has now and may have in a year.
3. What would cause you to ask a resident to move out? Every home has limits; you want to know them in advance.
4. How do you communicate with families about changes in condition?

Cost and payment

1. What is the monthly rate for my parent's level of care, and exactly what does it include?
2. What is billed separately? Common extras are incontinence supplies and nurse delegation fees.
3. Is there a move-in or assessment fee? How and when do rates increase?
4. Do you accept Medicaid, and what happens if my parent runs out of private funds? Policies range from accepting Medicaid at admission to requiring several years of private pay first. Get the answer in writing.

Daily life

1. Are rooms private or shared? Private bath? Can we bring furniture?
2. What did residents eat yesterday? A specific answer means home cooking. Ask about special diets and cultural food preferences.
3. What did residents do yesterday afternoon? Washington requires activities other than television. Look at what residents are doing while you visit.
4. What are the visiting hours, and can family join for meals or birthdays?

What to notice without asking

Does the home smell clean? Are residents dressed, groomed, and out of bed at a reasonable hour? Do caregivers speak to residents by name and at eye level? Is the person giving the tour the same person who will be there tomorrow? Do they answer your questions directly, or steer you back to a script? Trust what you see over what you are told.

After the tour

Go home and look the license up. Read the inspection reports. Call back with the questions you forgot; how the home handles a second call tells you how it will handle a concern later. And if you are touring Silvergate in Bonney Lake or Buckley, bring this list. We would rather you ask.