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Questions to Ask to Find the Best Assisted Living Facility

Questions to Ask to Find the Best Assisted Living Facility
Medicaid Planning
Jason Neufeld
January 22, 2024

While most of my clients in Florida prefer to live in their home for as long as possible and come to our firm to help protect their assets to get help paying for home-health care through the Medicaid Waiver program, there may still come a point when living at home is no longer practical. This is when one’s needs and care exceed what can be provided by home-health care agencies.  

The next step on the long-term care spectrum, usually, is moving into an Assisted Living Facility (ALF). ALFs should not be confused with nursing homes or skilled nursing facilities. You may find this article explaining the differences between an ALF and Nursing Home.

But finding the right Assisted Living Facilities for yourself or a loved one requires asking a few big questions concerning: safety, quality of care, quality of staffing, social opportunities, demographic fit, and, of course, affordability. 

Where to Start Researching Assisted Living Facilities?

First, consider whether you already have names of ALFs that you are interested in researching or whether you are looking for names of ALFs, in a particular region, to research.  

Obviously, if you have friends or family who have lived in a local Assisted Living Facility, their experience will provide you within valuable information. But that information is not always available.

Where Do I Start If I Don’t Know Any Assisted Living Facilities in My Part of Florida

Certainly, if you have friends or relatives who have direct experience with Assisted Living Facilities, that is a great place to start. However, I am also a fan of ALF Placement Specialists (sometimes referred to as ALF referral services). They are basically real estate agents for ALFs.  

Not all ALF Placement services, as with any profession, are equally as diligent, experienced and useful. These are usually small businesses with one or two employees who have developed relationships with multiple ALFs in their area. There are a few large national ALF placement companies that heavily advertise, but I do not find them to be as helpful as the local assisted living facility placement services who live and work in the same community.  

A good local ALF placement specialist will know of recent management changes, staff to resident ratios, improvements/degradations in quality of care, which facilities handle which specific resident needs, etc.  

ALF Placement Specialists do not charge the individual seeking the best assisted living facility, instead they get paid a commission by the ALF itself.  While this is an initially attractive feature of the service, it's also why it's important to use an ALF referral services with a track record of keeping the elder Floridian’s best interest as their primary focus.  

As an experienced elder law attorney serving all of Florida, we have relationships with high-quality ALFs and ALF Placement Services indifferent parts of the state.

How to Research a Specific Assisted Living Facility in Florida

Once you have a few Assisted Living Facility names to check out, you would then likely want to: get a tour and check for how they pass (or fail) state inspections.  

What to Look for When touring an ALF

This Washington Post article gives some good advice:  

  1. Is there a secure area outside where residents can enjoy fresh air without leaving the ALF premises?
  2. Are the resident rooms and common areas clean or does it smell?
  3. What kind of amenities are offered?
  4. Notice how staff interact with ALF residents. Do they speak to the resident by name? Seem frustrated/short staffed? Visit the Assisted Living Facility more than once, at different times of the day, to see if this changes.
  5. Are ALF administrators willing to introduce you to family members of other current residents to discuss their experiences?
  6. Give examples of some difficult behaviors your family member might exhibit from time to time and ask how the ALF would handle this situation.
  7. What is the typical staff to resident ratio during the day and at night?
  8. How often does the ALF cost increase?
  9. Does the facility accept Medicaid Waiver benefits?  

Where to Find Florida Assisted Living Facility Inspection Reports and Citations/Deficiencies

In Florida, the Agency for Healthcare Administration (AHCA) provides pretty easy access to Statement of Deficiencies (for ALFs, nursing homes, homecare agencies, adult daycare centers, hospitals and more)   

These and other inspection reports can also be found using the Florida Health Finder tool

Keep in mind that no ALF is perfect, they will all have demerits. You want to pay closer attention to the type of deficiency noted and how long ago the facility was cited. 

How to Pay for Assisted Living Facility Care in Florida

As this CBS News article explains, ALFs can be very expensive (especially with the need for memory-care). Smaller assisted living facilities are usually the least expensive.   

For those who are young and healthy enough, private long term care insurance gives you more options and flexibility. But age and health (preexisting conditions) play a large role in the cost of monthly premiums. It's also helpful to note that long-term-care insurance is no longer necessarily a “use it or lose it” product. There are now hybrid LTC life insurance policies that have a death benefit available if no or limited long-term care payouts are needed when the insured passes away. 

For those who do not have private long-term care insurance, the VA offers an improved pension for certain veterans (and their spouses) who need long-term care.  

For those who cannot afford long-term care costs in an ALF (with or without private long-term care insurance and/or VA benefits), in Florida, the Medicaid Waiver program can help pay for the cost of a participating Assisted Living Facility.  

Not all Assisted Living Facilities accept Florida Medicaid Waiver, but plenty of very nice facilities do. But even in the ALFs that accept Medicaid Waiver, those Medicaid benefits only pay for the “level of care” or medical portion of the ALF bill. Florida Medicaid Waiver will not cover the rent/ room and board portion of the monthly ALF bill. 

For this reason, Medicaid Planning is a great tool to assist those who have not yet lost all of their life savings. An experienced Medicaid planning lawyer can legally and ethically protect your assets: without having to wait five years, without having to sell your home, and without having to go broke first. If interested in speaking with a Medicaid planning attorney anywhere in Florida, please schedule a consultation with our office today.  

Jason Neufeld

Jason Neufeld is the Founder and Managing Partner of Elder Needs Law, a Florida estate planning and elder law firm he created in 2017. With more than 15 years of experience practicing law, he represents clients in a wide range of legal matters, including Medicaid planning, estate planning, elder law, probate, Medicare, and life insurance.

Jason received his Juris Doctor from the University of Miami — School of Law and is a member of the Florida Bar and the Broward County Bar Association. He has received numerous accolades for his work, including being named a Rising Star and Super Lawyer by Super Lawyers and among the Florida Legal Elite by Florida Trend in 2024.

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