Assessing Assisted Living Quality: Consumer Reviews, Ratings & Complaints

3 Ways to Assess Assisted Living Quality

How does one assess the quality of care provided in a specific assisted living residence? This is a concern held by many families and especially by those who are seeking care in less expensive assisted living residences. While there is no substitute for visiting the community, doing so only provides one view. Furthermore, as tours are most commonly given by marketing directors, a visitor is likely to only see the highlights of the community.

Fortunately, there are options to help families determine the quality of care their loved one will receive. Unfortunately, accessing this information is not always easy and the data can be inconsistent and confusing. There are three methods by which one can evaluate the quality of care and the quality of life in general in assisted living. In this article, we examine the pros and cons of each approach as well as the "how-to's". Our recommendation is families pursue all three approaches to gain a well-rounded view.

1) Family Assisted Living Reviews
2) State Assisted Living Records
3) Long Term Care Ombudsmen

 Ask Anyway - Assisted living satisfaction surveys exist, but these are not standardized, usually conducted by the residences themselves and their results are not published.  Families might request a copy of the latest survey when visiting a community.  It cannot hurt to ask. 

Pros & Cons of Each Approach

Approaches to Assessing Assisted Living Quality 
ApproachProsCons
Family Reviews -Fast and easy access to information
-Easy to compare residences
-Reviews are available for most residences
-Reviews are not very detailed
-False reviews exist if not verified
State Assisted Living Records -Data is not biased -Time consuming to access reports
-Difficult to understand data
-Comparing residences is nearly impossible
-Very focused on the negative
Long Term Care Ombudsmen -Information provided by humans -Difficult to reach / slow access
-Focused on the negative



 

1) Family Assisted Living Reviews

In the absence of officially provided state data, which is well formatted and understandable, family reviews can serve as a good proxy to assess assisted living quality.  The largest advantage of family or 3rd party reviews of assisted living communities is, by far, the ease of access to the information.  One can simply visit any of number of websites that offer reviews and search for their community of choice.  Reviews are available for nearly all residences with the exception of minor adult foster care home with 1-4 residents.  Reviews are easy to understand and it is simple to compare several residences to determine those that provide the best care.  The primary drawback of family reviews is that they not very detailed.  Reviews tend to be brief.  One must take caution to find a site that verifies its reviewers because false reviews abound.

Assisted Living Review Websites

Senior Advisor - Recommended. This site has a large number of reviews, is free to use and verifies all its reviewers.
Yelp - Typically reviews are more in depth, but most communities have not been reviewed.  Best used as a secondary source.
Angie's List - highly verified, in depth reviews.  Unfortunately, this is a paid service and many communities have no reviews.  

 

2) State Assisted Living Records

Assisted living records maintained and provided by the states have one large advantage, and unfortunately, multiple disadvantages.  The advantage is that the data in completely verified.  However, because only complaints are collected and violations tracked, the view tends to be biased towards the negative.  A wide range of types of data may be provided such as inspection reports, violations, citations, complaints, investigations and plans of correction.  As of 2016, 36 states and Washington DC were making assisted living quality data available to the public online. 

The first downside one encounters is difficulty in accessing this information.  Access is certainly easier in some states than others (see the table below), but in all states that make the information available, a clunky and confusing database search is required.  If information is available, it can be difficult to understand.  Violation codes may be used without definitions, scoring scales might not be provided and inspection reports may be hand-written and scanned.  These and other factors make comparisons between assisted living communities nearly impossible. 

 Did You Know?  There is no federal oversight of the assisted living industry. Each state has different inspection schedules, licensing requirements and enforcement.  Learn about Staff-to-Resident ratios.

If one is looking for positive information about the communities, the state records are not the place to look.  Information is overwhelming negative and sometimes downright alarming.  This is due to the fact that vast majority of information the state collects is from inspections, enforcements and complaints.  Should a search encounter a lack of information from the state, the meaning is ambiguous.  It might be interpreted positively as a lack of complaints and violations means there is nothing to report. On the other hand, it could mean that state inspections are infrequent.  For example, California only requires one inspection every 5 years.  A third possibility is that it is simply a reflection of shoddy record keeping.  Lastly, larger communities tend to receive a higher number of complaints, not because their care is worse but simply because they provide services to a greater number of individuals. 

State assisted living databases are best used when one has already selected a community and they just want to make certain that that community has no major history of resident neglect.  The table below lists what information each state provides online and links to that state's database. 

State by State Assisted Living Records Access

State

Description

Report Access Link

Alabama

Publishes deficiencies by date online

View Reports

Alaska

Does not publish information online

 

Arizona

Publishes surveys and enforcements if available

View Reports

Arkansas

Does not publish information online

 

California

Does not publish inspection information online. Inspections occurs only every 5 years.

 

Colorado

Publishes surveys and investigation reports online

View Reports

Connecticut

One can view a list of organizations that have been penalized

View Reports

Delaware

Publishes annual survey and complaint investigations

View Reports

Florida

One can view inspection reports and any deficiencies

View Reports

Georgia

Provides inspection reports and complaint investigation reports

View Reports

Hawaii

Does not publish information online

 

Idaho

One can view complaints and inspection reports by community

View Reports

Illinois

Complaints and citations are published online. Search by community name or location.

Offline

Indiana

One can see the number of complaints and inspection reports

View Reports

Iowa

One can view "Report Cards" by residence that contain the number of complaints and their inspection reports.

View Reports

Kansas

One can view Deficiency Reports and Plans of Correction by residence.  Be forewarned that their database can be very slow.

View Reports

Kentucky

Kentucky does not publish assisted living quality information online yet

 

Louisiana

No information published about inspections or violations

 

Maine

The state does not make assisted living quality information available online

 

Maryland

Inspection reports and citations are available by residence

View Reports

Massachusetts

Surprisingly, MA does not publish assisted living quality information online. This is expected to change

 

Michigan

Inspection reports, complaints and violations are available by residence

View Reports

Minnesota

One can view complaints that have been substantiated and those that have not

View Reports

Mississippi

Miss. does not publish assisted living quality information online

 

Missouri

Violations and plans of correction are available by residence

View Reports

Montana

MT does not publish information about assisted living quality online

 

Nebraska

One can search by residence for violation records and plans of corrections

View Reports

Nevada

Nevadans can view assisted living citations by name or city

View Reports

New Hampshire

One can submit complaints and view violations online

View Reports

New Jersey

One can view inspections and violations by residence

View Reports

New Mexico

One can view citations and complaints however their online database is only working intermittently.

View Reports

New York

One can view violations by date of inspection.  Difficult to use because one does not know the last date any community was inspected and must review multiple pages until they find their desired community

View Reports

North Carolina

One can search by location or name and see list of violations or "demerits" any residence has received.

View Reports

North Dakota

ND does not make information on assisted living community care quality available online

 

Ohio

Ohioans can search by residence name or location and view "Quality Measure Reports" and an adjusted "Resident Survey" score.

View Reports

Oklahoma

One can view Inspection Reports and any deficiencies for which a residence was cited.

View Reports

Oregon

One can search by location or residence name for complaints, and can see whether or not they were substantiated.  Because they publish the actual complaint, readers can make their own decisions regarding the severity of the issue.

View Reports

Pennsylvania

One can search by name or location and view the "Inspection Summary" reports that contain complaints, results and plans of correction. 

View Reports

Rhode Island

RI does not publish assisted living quality information online

 

South Carolina

One can view sanctions taken against residences however in order to find information on a specific community one must search backward through multiple pages.  

View Reports

South Dakota

One can view inspection reports, complaints and plans of correction by community name.

View Reports

Tennessee

One can view a history of disciplinary actions taken against providers, but the webpage lacks of the ability to search and, therefore, one must painstakingly review all past actions to find their community of interest.

View Reports

Texas

One can search by residence name or location and view complaints, inspections and violations

View Reports

Utah

No information about assisted living quality is available online

 

Vermont

One can view inspections, violations and complaint investigations by community

View Reports

Virginia

One can view inspections, violations and complaints by community or by location

View Reports

Washington

One can view violations and other reports by residence.

View Reports

Washington, D.C.

One can view deficiencies and plans of corrections by residence

View Reports

West Virginia

WV does not publish assisted living care quality information online

 

Wisconsin

One can view reports, deficiencies and plans of correction

View Reports

Wyoming

One can view deficiencies and plans of correction.  Violations may be difficult to interpret as violation codes may be used.

View Reports

3) Long Term Care Ombudsmen

LTC Ombudsmen are state employees charged with investigating complaints in residential care and providing information to help families find quality care.  The big advantage of Ombudsmen is that one can speak with a real human about the quality of care provided in an assisted living residence.  The downside is that many Ombudsmen are simply overwhelmed by requests and gaining access for an in-depth conversation may be difficult. 

There are over 1,100 persons working in the ombudsman program nationwide.  Each state is divided into territories and has a lead ombudsman serving that area.  One can find their local ombudsman here.