What is the first step in choosing senior living?

Match the care level to what your parent needs each day and may need next. This determines whether you should consider independent living, assisted living, memory care or a nursing home.

How many communities should we visit?

NIA recommends visiting several facilities in person before deciding and meeting the director, nursing director or other key staff.

How do I know if a community is good?

Check inspection records through Care Compare for nursing homes or the state licensing agency for assisted living. Read reviews for patterns, tour more than once and talk with other families. Care Compare rates nursing homes from 1 to 5 stars (CMS).

How close should the community be to family?

Choose a location close enough for family and friends to visit easily, which NIA lists as a factor to weigh.

What should I check in the contract?

Review the care-level fee schedule, rate increase history and notice, refund terms, and the conditions for discharge. Discharge or eviction heads the list of the most frequent complaints ombudsmen handle in assisted living (ACL, FY2023).

Where can I find free help choosing?

The Eldercare Locator (800-677-1116), your local Area Agency on Aging and Medicare's Care Compare are free public resources (NIA).

How much should we budget for assisted living?

The 2024 national median was $5,900 a month (CareScout). Calculate the full cost at your parent's care level and check your state's figures.

Can my parent move to a higher level of care later?

Often, if the community offers it. Continuing care retirement communities offer independent living, assisted living and skilled nursing on one campus (NIA). Ask each community which needs it cannot meet.

How to Choose a Senior Living Community: Step-by-Step Guide

Families often face this decision after a fall or hospital stay, when time is short. These steps help keep the process in order.

Step 1: Match the care level

Start with the help your parent needs during a normal day, including bathing, dressing, medications, meals, mobility and memory changes. Consider what they may need a year or two from now, since care needs tend to increase.

If your parent...	Look at	What it provides
Lives independently but wants meals, upkeep and company handled	Independent living	Housing with services, no personal care in the base price
Needs help with bathing, dressing or medications	Assisted living	Up to three meals a day, help with personal care and medications, housekeeping, 24-hour supervision (NIA)
Has Alzheimer's disease or another dementia and safety risks	Memory care	Assisted living services in a secured setting with dementia programming
Needs nursing care or 24-hour medical supervision	Nursing home (skilled nursing facility)	Nursing care, 24-hour supervision, meals, and physical, occupational and speech therapy (NIA)
Wants to stay at home with help	Home care	Paid help at home, from personal care to companionship
Wants one campus that covers future needs	Continuing care retirement community	Independent living, assisted living and skilled nursing in one location (NIA)

These needs are common. In 2020, 50% of residents of residential care communities, which include assisted living, were 85 or older, and 42% had Alzheimer's disease or another dementia (CDC). For a detailed comparison, read Independent living vs assisted living vs memory care vs nursing home.

Step 2: Set the budget from the full cost

Use the total monthly cost, including the care-level fee, rather than the advertised "starting at" rent. The 2024 national median was $5,900 a month for assisted living, $9,277 for a semi-private nursing home room and $10,646 for a private room (CareScout Cost of Care Survey).

Next, determine who will pay. Medicare doesn't pay for long-term care (Medicare.gov). Medicaid, long-term care insurance and VA benefits can help in some cases. Read How senior living pricing works and Who pays for senior living before creating your shortlist so every option fits the budget.

Step 3: Shortlist by location

Distance affects both the resident and the family. NIA lists "staying close to family and friends so they can easily visit" as a factor to weigh. Being near your parent's doctors and familiar neighborhoods may also ease the move.

Free public tools for finding local options include the Eldercare Locator (800-677-1116) and your local Area Agency on Aging (NIA). Our directory lists 21,588 approved communities in 7,597 cities across all 50 states and DC, including 5,835 that list assisted living, 3,793 memory care and 2,555 independent living (USR directory data, October 2, 2026).

Step 4: Check records and reputation

For nursing homes, Medicare's Care Compare gives each nursing home an overall rating from 1 to 5 stars, along with separate ratings for health inspections, staffing and quality measures. CMS treats the health inspection rating as the most important part of the overall rating (CMS Five-Star Quality Rating System).
Assisted living and memory care are licensed by states. Ask the community for its latest state inspection report and check the state licensing agency.
Of the 6,680 communities in our directory with a Google rating, the median is 4.5 stars on a median of 35 reviews, and 332 are below 3.5 (USR directory data, October 2, 2026). Look for patterns in the low reviews.
Our listings connect 7,770 communities to one of 309 management companies (USR directory data, October 2, 2026). Ask who operates each community and review that operator's other communities.
NIA suggests asking friends, family, health care providers and social workers about their experience with particular facilities.

Step 5: Tour more than once

NIA recommends visiting several facilities in person and meeting "the director, nursing director, or other key staff members." If possible, visit at different times of day and eat a meal. Watch how staff speak to residents. NIA lists "warm and respectful interaction between staff and residents" among the things to look for.

Take our 40-question tour checklist and ask each community the same questions. Consistent questions make the answers easier to compare.

Step 6: Read the contract

NIA advises reading the contract carefully, asking about anything unclear and reading it "again before signing it." Pay close attention to the care-level schedule, rate increases, refund terms and the conditions under which a community can ask a resident to leave. Discharge or eviction heads the list of the five most frequent complaints long-term care ombudsmen handled in assisted living and similar communities in federal fiscal year 2023 (Administration for Community Living).

If a problem arises after the move, every state has a Long-Term Care Ombudsman program that works on problems for residents of nursing homes, assisted living and board and care homes (ACL).

The six factors at a glance

Factor	What to weigh	Where to check
Level of care	Current and likely future needs: daily help, medical support, memory care	Doctor, community assessment
Location	Distance to family, friends, doctors and familiar places	Map, Eldercare Locator
Budget	Full monthly cost at the assessed care level, one-time fees, who pays	Fee schedule, payer rules
Amenities and activities	Dining, activities and services that fit your parent's interests	Tour, activity calendar
Tour and visit	Staff interactions, cleanliness, atmosphere, at different times of day	Two or more visits
Safety and reputation	Inspections, licensing, reviews, staffing	Care Compare, state agency, reviews

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How to Choose a Senior Living Community: A Step-by-Step Guide