Assisted Living Quality: Common Threads

Over the past few weeks, we’ve been conducting some market research in planning for an up-and-coming project here at As part of this, we talked to a number of geriatric care managers (GCMs) based in different areas across the U.S.

The process was very informal, and we didn’t gather official stats or metrics. Still, through our casual interviews we discovered there’s a clear consensus surrounding the characteristics that set a top-notch assisted living community apart. We came up with a list of the most essential services and qualities today’s seniors, families and GCMs expect from an assisted living home. Take a look at our findings to see if your facility is on-target.

Certain qualities help assisted living facilities stand out

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Customized care, hands-on staff and quality training

By and large, customized care is an essential component of assisted living homes. Some GCMs even said they prefer smaller facilities, because staff are more able to notice minute changes in a resident’s care needs and can quickly make modifications to the plan of care. All expect that residents needs will be met on an individual basis, not as a one-size-fits-all program. Staff should be hands-on and receive ongoing quality training. Other GCMs don’t feel small facilities are absolutely necessary if individual needs are met, which brings me to our next point:

Adequate staff-to-resident ratios

Even in the largest assisted living facilities, customized care doesn’t have to be a problem if the staffing ratios are adequate. Ratio requirements are usually dictated by law, but specific numbers vary from state to state. Ratios can even vary within a single facility. For instance, if an assisted living home has a wing dedicated to dementia care, staff-to-resident ratios could be lower than those in other areas. Clearly, all providers must abide by their own state laws, but those who go above and beyond with extra staffing earn bonus points.

Low staff turnover

Speaking of staff, turnover is a big issue for GCMs. Most feel that if staff turnover is high, there are problems within the facility. Whether these issues are directly tied to care doesn’t matter: Unhappy staff don’t do their jobs as well as employees with high levels of job satisfaction.


You wouldn’t want to live in a dirty home, would you? Residents don’t either, and their family members don’t want to make a visit and get the impression the facility isn’t clean.

24-hour nurses

In some states, round-the-clock nurses aren’t required by law in assisted living facilities. Most typically have a registered nurse on-call at all times and a nurse that works in the facility at least part-time. Care managers prefer facilities with 24-hour nursing, especially for proper medication management.

Quality of care and activities

Quality of care is a no-brainer. Mistakes should be minimal, neglect should never be an issue and resident care should pass the bar at all times. Part of the care provided in any senior living community is providing meaningful activities for residents. Going beyond the old standbys with an activity director who can come up with new, creative activities, events and outings will help set your facility apart from the pack.

Homelike environment

The entire healthcare industry is shifting to a patient-centric model, and senior living is no exception. Assisted living homes shouldn’t feel institutional or like a hospital. Comfort and accessibility should be primary design considerations, and allowing residents to bring furnishings and other items from home increase the home-like feel.

Fine dining

Assisted living homes must offer good food

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Five-star restaurant? You bet. It’s not out of reach for today’s seniors. Dining options should be numerous and meals delectable. Many assisted living residents enjoyed satisfying home-cooked meals most of their lives, whether prepared by themselves or  a spouse, so why should senior living veer from that standard? And choices are crucial. Seniors prefer to maintain as much control over their own lives and schedules as possible, and choosing their own meals is a big part of that. Dining rooms set up in restaurant-style that can accommodate family and other special guests are also a plus.

Using fresh ingredients and avoiding mass-quantity processed foods not only produces tastier foods, but it’s healthier as well. Fresh ingredients have higher vitamin and mineral content than packaged and processed ingredients and contain less preservatives, like salt and other additives that can be bad news for special diets.

Good economic standing and stability

Finally, we talked with a number of GCMs who say they look for communities in good economic standing. It’s not unheard of for assisted living homes to suddenly switch hands in the current economic climate. Changes in ownership can lead to management changes, resulting in sudden modifications of residents’ routines, new policies and even vendor switches that can really muck up a senior’s carefully regimented and preferred routine. An assisted living facility with a healthy census and no major financial struggles are usually a wise choice.

Are we missing anything? What do you think are the most essential qualities of a great assisted living facility? Would you add or delete any items from this group? And if you’re a senior or caregiver who has been searching for senior housing, how many of these considerations are you using to evaluate potential facilities? Be sure to let us know in the comments.

Certain qualities help assisted living facilities stand out

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