Ask one question above all others: how many trained staff are on the floor at 2am? Not how many are employed. The number physically present overnight, when a fall happens and nobody is watching.
A home that answers with a figure and offers to let you come and see it is a different kind of home from one that says "we have staff round the clock, don't worry". That difference, repeated across fifty questions, is how you choose.
This matters more in India than elsewhere, because no authority licenses or inspects a private assisted living facility here. Nobody has checked on your behalf. The questions below are the inspection.
Key takeaways
- Four questions on the phone will rule out half your shortlist before you spend a Saturday driving to homes that were never right.
- The unannounced mealtime visit tells you more than the other four stages combined. Never sign without doing one.
- The 2am staffing question is the highest-yield question there is. Vagueness in the answer is itself the answer.
- Ask what happens as care needs rise, specifically bedridden care and dementia. A home that stops at your parent's current level means a second move at the worst possible moment.
- Ask for the exclusions list, not the brochure. The gap between the quoted fee and the real bill lives there.
- Judge the shape of the answer. Specific, checkable and willing to admit a limit is good. Reassuring and unfalsifiable is not.
How to use these questions
Fifty questions, in the order that saves you wasted visits.
Five stages, in this order:
- The phone screen. Eight questions, fifteen minutes each, before you go anywhere.
- The scheduled tour. Twenty questions asked while you walk.
- The unannounced visit. Arrive at a mealtime with no appointment. Ask nothing at first.
- The care assessment. Six questions about the level assigned and what moves your parent up.
- The agreement. Sixteen questions before you sign anything.
Filled means ask it here. Half means follow up here. Cross means it is too early or too late.
Stage 1: the phone screen, 8 questions
These exist to rule homes out cheaply.
- What care levels do you run, and what is the highest?
- Are you staffed for someone who needs help with [name the specific tasks]?
- Do you have availability now, and is there a waiting list?
- What is the all-in monthly cost for that care level, including the care charge?
- What is the admission fee and the security deposit?
- What registration and accreditation do you hold?
- Do you accept a resident who later becomes bedridden or develops dementia?
- Can we visit unannounced as well as on a scheduled tour?
A hesitation on question 8 is worth more than a good answer to the other seven.
Stage 2: the scheduled tour, 20 questions
On staffing, 5
- How many trained care staff are on the floor during the day, for how many residents?
- How many are on the floor at 2am?
- Is there a nurse on site overnight, or on call?
- What is your staff turnover in the last year?
- What training do caregivers receive, and who delivers it?
On medical cover, 5
- How often does a doctor visit, on what fixed schedule?
- Which hospital do you tie up with, and how far is it in traffic rather than kilometres?
- Is an ambulance on site or called?
- What happened at your most recent medical emergency?
- How are medicines stored, dispensed and recorded, and may I see the register?
Question 17 is the one to press on. A specific recent story tells you the escalation route works. "Nothing has ever happened here" tells you either the home is new or the incident log is not kept.
On daily life, 5
- Walk me through an ordinary Tuesday, hour by hour.
- May I see today's menu, and the food actually being served?
- How are medical diets handled: diabetic, renal, low salt, soft or pureed?
- What activities run, and how many residents actually attend?
- What are the visiting rules, and can we come at any time?
On the room and the building, 5
- May I see the room my parent would actually have, not the show room?
- Is there a call button at the bed and in the bathroom, and can we test one?
- Are there grab rails, anti-skid flooring and outward-opening bathroom doors?
- What is the space per resident, and what is the arrangement for a couple?
- May I see the isolation room, the kitchen and the nursing station?
Questions 25 to 28 map directly onto India's Minimum Standards for Senior Citizen Homes, published in March 2024, which asks for a call button at every bed, grab rails, anti-skid tiles, outward-opening bathroom doors, 7.5 sq m of bedroom area per resident and a four-bed isolation room. Nobody enforces that document, which is exactly why it makes a good checklist. The full picture is in assisted living regulations in India.
Stage 3: the unannounced visit
Not a question list. A visit at a mealtime with no appointment, where you mostly watch.
What to observe:
- Smell. The most reliable single indicator of care quality there is.
- Whether staff use residents' names, and whether residents look at them when they speak.
- The food actually being served, against the menu on the wall.
- How many residents are out of their rooms at 11am on an ordinary weekday.
- Whether call bells are being answered, and how long they ring.
- The state of the bathrooms, not the lobby.
- Whether residents look groomed: hair, nails, clean clothes.
- How staff speak to each other. Exhausted, resentful staff do not deliver good care however good the policy is.
Then ask two questions:
- May I speak to a resident, and to a resident's family member, without staff present?
- May I see the incident log?
A refusal on question 29 ends the visit. Good homes offer it before you ask.
Stage 4: the care assessment, 6 questions
- Will you assess my parent in person before offering a place?
- What care level would they be placed in, and on what basis?
- May I have the written care plan, naming what is included at that level?
- What specifically triggers a move to the next level?
- How much notice do we get before the fee changes?
- Who reviews the level, how often, and is the family present?
A home that offers a place without assessing your parent is a warning sign rather than a convenience. Levels carry no legal meaning in India, so the definition matters and the label does not. Both are covered in levels of care in assisted living and assisted living eligibility criteria.
Stage 5: the agreement, 16 questions
On money, 8
- What is in the base fee, in writing?
- What is your exclusions list?
- Are medicines billed at cost, or with a margin?
- How many physiotherapy sessions a month are included?
- What is the annual increment, and what has it actually been for the last three years?
- Is the security deposit refundable, in full, and within how many days?
- Will you bill medical items separately from room and board?
- What are the charges if my parent is in hospital for a month?
Question 43 is the one families skip and regret. Without a split between medical items and room and board, the Section 80D and 80DDB deductions cannot be claimed, and it cannot be fixed retrospectively. The detail is in does insurance cover assisted living in India.
On the relationship, 8
- What is the notice period, on each side?
- On what grounds can you ask a resident to leave?
- What happens if my parent becomes bedridden?
- What happens if my parent develops dementia?
- Who is our named escalation contact, and what is their direct number?
- Is there a residents' committee, and does the family get a say?
- May I see the residents' rights charter and the resident handbook?
- Do you offer a trial stay?
Questions 47 and 48 decide whether you will be doing this again in eighteen months. Ask them of every home, and take a vague answer as a no.
The six questions that reveal the most
If you only get six, make them these.
If time is short, or a parent is being discharged from hospital next week, these six do most of the work:
- How many trained staff are on the floor at 2am?
- Will you keep my parent if they become bedridden, and if they develop dementia?
- What is your exclusions list?
- What happened at your last medical emergency?
- May I speak to a resident's family, without staff present?
- What has your fee increase actually been for the last three years?
Ask all six of every home. The answers are comparable in a way that amenity lists never are.
It is not the question, it is the answer
The same six questions, answered by a home worth choosing and a home worth leaving.
Two homes can answer the same question and tell you completely different things.
On night staffing. Good: "Two carers and one nurse, for 34 residents. Come at 11pm and see." Bad: "We have staff round the clock, don't worry about that."
On emergencies. Good: "Last month, a fall at 4am. Apollo, 18 minutes in traffic. Here is the incident log." Bad: "Nothing has ever happened here."
On fees. Good: "₹48,000 at level two. Here is the exclusions list. Medicines are billed at cost." Bad: "It depends. We'll work it out. Most families pay about that much."
On talking to residents. Good: "Of course. Mrs Nair's daughter visits on Sundays, I'll introduce you." Bad: "Residents rest in the afternoon. Better to just see the rooms."
On rising needs. Good: "We run levels one to three and keep bedridden residents. Dementia we cannot, and I'd rather tell you now." Bad: "We take care of everything. Whatever they need, we manage."
On paperwork. Good: "Here is the registration, the agreement and the residents' rights charter." Bad: "The office handles that. Pay the token today and we'll sort it out."
The pattern: specific, checkable and willing to name a limit is a good answer. Reassuring and unfalsifiable is not. A home that admits what it cannot do is telling you the truth about what it can.
Eight answers that should end the visit
- "We don't allow unannounced visits."
- "Residents can't be disturbed" when you ask to speak to one.
- "We take everyone" when you ask about dementia or skilled nursing.
- "Nothing has ever gone wrong here."
- "We don't have a written agreement, we work on trust."
- "Cash only" or no receipt.
- "This price is only if you confirm today."
- Any vagueness about who is physically present overnight.
The wider red flag list is in are old age homes safe in India.
Questions for particular situations
If your parent has dementia, there are fourteen additional questions on the secure perimeter, dementia training, restraint policy and staging, in assisted living for dementia patients.
If you are still deciding whether assisted living is right at all, start with counting the activities of daily living in who needs assisted living, and weigh it up with the pros and cons of senior living.
If you are comparing against a retirement home, the difference is set out in assisted living vs retirement home.
If you want to know what should be included before you ask what costs extra, see what services are included in assisted living.
The bottom line
Fifty questions is a lot, and you will not need all of them at every home. Four on the phone will do most of the filtering. Six on the tour will do most of the deciding.
What matters more than the list is what you do with the answers. Judge the shape, not the content. A home that gives you a number, offers to let you verify it, and tells you plainly what it cannot handle is a home that knows its own limits. A home that reassures you about everything has either not thought about it or does not want you to.
And whatever else you skip, do the unannounced mealtime visit. In a country where no regulator will do it for you, that hour is the closest thing to an inspection your parent will ever get.
Ready to shortlist? Elkin verifies registration, care levels and staffing before listing, so you can compare assisted living communities across India by care level, city and budget.
Frequently asked questions
What questions should I ask an assisted living facility?
Start with care levels, availability, all-in cost and registration on the phone. On the tour ask about staffing during the day and at 2am, nursing cover, the doctor's schedule, the tie-up hospital, medication handling, the daily routine, the food and the actual room. Before signing ask about the exclusions list, the annual increment, refund terms, the notice period and what happens if your parent becomes bedridden or develops dementia.
What is the single most important question to ask?
How many trained staff are physically on the floor at 2am, for how many residents. It is the number that determines what happens when your parent falls at night, it is rarely on any brochure, and vagueness in the answer tells you as much as a figure would.
What should I look for when visiting an assisted living facility?
Smell, first. Then whether staff use residents' names, the food actually being served against the menu on the wall, how many residents are out of their rooms mid-morning, whether call bells are answered promptly, the state of the bathrooms rather than the lobby, and whether residents look groomed. Visit unannounced at a mealtime as well as on the scheduled tour.
What questions should I ask about assisted living costs?
What is in the base fee in writing, what is on the exclusions list, whether medicines are billed at cost or with a margin, how many therapy sessions are included, the annual increment and what it has actually been for three years, whether the deposit is fully refundable and within how many days, and whether medical items will be billed separately from room and board.
What are the red flags when touring an assisted living facility?
Refusing unannounced visits, refusing to let you speak to a resident or a resident's family, claiming to take everyone regardless of care needs, claiming nothing has ever gone wrong, no written agreement, cash payments without receipts, pressure to confirm today, and vagueness about overnight staffing.
Should I visit an assisted living facility unannounced?
Yes, and it is the most useful visit you will make. A scheduled tour shows you the best room on the best day. An unannounced arrival at a mealtime shows you an ordinary Tuesday. A home that refuses one has told you something important.
What should I ask about care levels?
Which level your parent would be placed in and on what basis, what that level includes in writing, what specifically triggers a move to the next level, how much notice you get before the fee changes, how often the level is reviewed and whether family attend. No Indian law defines a care level, so the definition matters and the label does not.
How many assisted living facilities should I visit?
Three to five, shortlisted from the phone screen, with at least two visited twice, once scheduled and once unannounced. Allow six to ten weeks. Families who start during a crisis usually take whatever has a bed rather than choosing.
Should my parent come on the visit?
Yes, on the scheduled tour at least. A senior who chooses their own home settles into it, and one who is placed in it usually does not. Shortlist three and let them decide between them.
