The biggest red flags are residents who look neglected, staff who avoid your questions, a community that will not show you its license or inspection reports, and fees that are not in writing. Visit more than once, including unannounced (National Institute on Aging). If you think someone is being harmed, report it.
Checklist for your visit
Take this with you, or print it. Leave a box unchecked if you could not confirm it.
People
The building
Daily life
Paperwork
Red flags when you talk to staff
- They cannot tell you how many care providers there are per resident, or what training they have (National Institute on Aging).
- Key staff change often. Ask how long the director and the heads of nursing, food and social services have been there (National Institute on Aging).
- They discourage you from visiting at other times, or from talking to residents and families.
- They pressure you to sign or pay a deposit today.
- They promise dementia care but cannot explain what it involves. Not all assisted living providers offer services designed for dementia (Alzheimer’s Association).
Warning signs once someone has moved in
The National Institute on Aging says an older person might be a victim of abuse or neglect if they (National Institute on Aging):
- Become withdrawn, or act agitated or violent
- Have unexplained pressure marks, bruises, burns, cuts or scars
- Develop preventable conditions such as bedsores
- Have hazardous, unsafe or unclean living conditions
- Look messy, with unwashed hair, dirty clothes or poor dental hygiene
- Lack personal items such as glasses, a walker, dentures or a hearing aid
- Have sudden and unexpected financial losses or unpaid bills
Watch for a pattern, and seek help if you are concerned.
Who to call
- Immediate danger: call 911 (National Institute on Aging).
- Suspected abuse or neglect: report what you see to your local adult protective services agency. You do not personally need to prove it. Professionals will investigate (National Institute on Aging).
- Complaints about a community: long-term care ombudsmen advocate for people living in assisted living and are trained to help resolve problems. You can find yours by calling 202-332-2275 (National Institute on Aging).
- Help finding local services: the Eldercare Locator at 800-677-1116 (U.S. Administration for Community Living).
Common questions
Should I visit without an appointment?
Yes, for a second visit. The National Institute on Aging suggests making a second visit without calling ahead, on another day of the week or at another time, and stopping by at mealtime.
Who do I call if I suspect neglect?
If someone is in immediate danger, call 911. Otherwise report it to Adult Protective Services or the long-term care ombudsman. You do not need to prove it. Professionals will investigate.
What does a long-term care ombudsman do?
Long-term care ombudsmen advocate for the needs of people who live in assisted living, board and care homes and nursing homes, and are trained to help resolve problems. You can find yours by calling 202-332-2275.
Related guides
What is assisted living?
What assisted living includes, who it is for, who regulates it, how fees usually work and what to ask before signing.
When is it time for assisted living?
The everyday signs that a parent may need more help, how to weigh them and how to start the conversation.
Assisted living vs. nursing home
How assisted living and nursing homes differ in care, oversight and who pays, with a side-by-side table and the official sources.
Sources
- How To Choose a Nursing Home or Other Long-Term Care Facility, National Institute on Aging (NIH). Checked November 8, 2026.
- Elder Abuse, National Institute on Aging (NIH). Checked November 8, 2026.
- Long-Term Care, Alzheimer’s Association. Checked November 8, 2026.
- Eldercare Locator, U.S. Administration for Community Living. Checked November 7, 2026.
This guide explains general rules. It is not medical, legal or financial advice for your situation. Program rules and amounts change, usually each January (Medicare and Medicaid) and each October (VA). Confirm details with the agency or a qualified professional before you decide. See our editorial policy.