Choosing a senior care facility is one of the most important decisions a family makes — and most families make it in a state of stress, time pressure, and incomplete information. A well-run facility tour is designed to show you the lobby, introduce you to the marketing director, and get you emotionally attached before you ask any hard questions. This guide gives you the 10-point checklist I use when I evaluate facilities for my clients. Use it before you sign anything.

Before You Tour: The Research You Should Do First

Spending 30 minutes on research before your first tour visit will save you from touring facilities that shouldn’t be on your list.

1. Check the state inspection record

For Texas assisted living facilities, inspection reports are available at the HHSC Health and Human Services website. For skilled nursing facilities, CMS Five Star ratings and inspection reports are at medicare.gov/care-compare. Look for: repeated deficiencies in the same category over multiple inspection cycles (this means the problem isn’t being fixed); “immediate jeopardy” citations (serious enough to immediately endanger resident health or safety); and staffing-related deficiencies. A facility with one isolated citation may be fine; one with a pattern of the same problems has a culture issue.

2. Look at staffing data

CMS publishes staffing data for skilled nursing facilities including registered nurse hours per resident day and total nurse staffing hours. Facilities significantly below state averages for their peer group are understaffed. For assisted living, staffing data is not publicly available — you have to ask directly. More on that below.

3. Check online reviews with appropriate skepticism

Google and Caring.com reviews reflect real family experiences, but they skew toward extremes — very happy families and very upset families are most likely to leave reviews. Look for patterns across multiple reviews rather than outliers. Pay particular attention to reviews mentioning specific staff names (indicates relationship quality) and reviews describing problems with how management responded to complaints.

During the Tour: What to Actually Observe

The tour is your opportunity to observe what the facility didn’t prepare you to see. Use it actively.

4. Observe staff-resident interactions, not just decor

The most important thing you’ll see on a tour has nothing to do with the building. Watch how direct care staff — aides, CNAs — interact with residents they encounter during your tour. Do they use residents’ names? Do they make eye contact and speak warmly? Do they seem engaged or distant and mechanical? A staff member who passes a resident in the hallway and ignores them has told you something important about the culture of that facility.

5. Visit at a non-peak time

If you only tour during the facility’s preferred tour window (typically 10am–2pm, when activities are scheduled and things look their best), you’re seeing a curated version of daily life. Request a second visit in the late afternoon or early evening — when activities are over, staffing often drops, and sundowning affects residents with dementia. What you see then is closer to what daily life actually looks like.

6. Talk to current residents (and their families)

Ask if you can speak with a current resident or a family member independently — not with a staff member present. The staff cannot legally prohibit this. A willing resident or family member will give you more honest information in five minutes than any tour will provide. Ask specifically: “Is there anything you wish you had known before choosing this facility?”

Questions to Ask That Most Families Don’t

The facility’s sales team is skilled at answering the questions families typically ask. These questions go beyond the standard script.

7. Ask about overnight and weekend staffing

“What is your staff-to-resident ratio overnight and on weekend days?” This is the question that reveals the staffing reality behind the marketing language. Many facilities staff generously during business hours (when tours happen) and cut to minimum levels overnight and on weekends (when no one is watching). A facility that can’t tell you the specific ratio, or that deflects to vague statements about “following all regulations,” is not being transparent. Demand a number.

8. Ask about staff tenure and turnover

“What is your average staff tenure and what was your aide turnover rate last year?” High turnover (above 40–50% annually for aides is common in the industry; below 20% is excellent) indicates management or workplace quality problems that directly affect resident care consistency. Residents with dementia in particular suffer when familiar staff leave and are replaced by strangers.

9. Ask how they handle medical emergencies and behavioral crises

“If my parent falls at 2am on a Saturday, what happens?” and “If my parent with dementia is extremely agitated and resisting care, what do your staff do?” The answers tell you about actual emergency protocols and behavioral management philosophy. A facility that defaults immediately to “we call 911” for all medical events or “we use medication” for all behavioral events has systems gaps. A facility with specific protocols for different scenarios has invested in training.

Before Signing: The Contract Review

Senior care residency agreements are legally binding contracts. Many families sign them without reading, under time pressure, with significant family stress affecting judgment. This is a mistake that can have real financial and legal consequences.

10. Understand the discharge and move-out provisions

Every assisted living residency agreement contains provisions that allow the facility to require a resident to move out — for non-payment, for care needs that exceed the facility’s capability, for behavioral reasons, or sometimes for administrative reasons. Read these provisions carefully. How much notice are you given? What is the appeal process? What happens to prepaid fees if you’re asked to leave? A facility that can ask your parent to leave with 30 days notice (standard) is different from one that requires 72 hours for behavioral emergencies.

The arbitration clause

Most Texas assisted living contracts contain mandatory arbitration clauses that waive your right to sue in court for disputes, including negligence claims. These clauses are legal in Texas. Understand that by signing, you are agreeing to resolve any future disputes through arbitration rather than a jury trial. Some families negotiate to have arbitration clauses removed; some facilities will agree, most won’t. Know what you’re signing.

Rate increase provisions

Read exactly how rate increases work: how much notice you receive, whether increases require board approval or are at the administrator’s discretion, and whether there is a cap. Facilities that have increased rates 10–15% annually can quickly move beyond a family’s budget even if the initial rate was affordable.

After You Choose: The First 90 Days

The placement decision doesn’t end at signing. The first 30–90 days after move-in are critical — this is when placement problems surface and when early intervention makes the most difference.

Visit in the first week — unannounced if possible — to see how your parent is settling in. Review the care plan with staff within the first 30 days to confirm that what was promised is being delivered. Address any concerns directly with the director of care rather than the admissions director (who sold you the placement and has an interest in minimizing problems).

A placement that isn’t working at 30 days is far easier to change than one that isn’t working at 6 months. Pay attention to your parent’s mood, weight, hygiene, and engagement level — and trust your observations.

Choosing a senior care facility well is a skill — and most families only do it once or twice in their lives, under significant stress. A placement specialist who has done this hundreds of times, who knows the specific facilities in your market, and who has ongoing relationships with facility staff can shortcut months of research and help you avoid the facilities that present well but don’t deliver. If you want guidance on evaluating specific Texas communities, I’m available for a free consultation.