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Adult Family Home

Preparing for the First Call, the Tour, and the Assessment

The first call is easier when you know its shape. It is a conversation, not an interview, and nothing you say commits you to anything. Most families begin by admitting they are not sure yet what their mother needs, which is a fine place to start.

What Happens on the First Call

Expect the owner or a nurse to ask about diagnoses, the medications and how they are given, what your loved one manages alone and what requires hands-on help, how they move and sleep and eat, and what changed recently that started this search. A hospital discharge, a fall, or a spouse who can no longer lift them are the usual triggers.

You do not need paperwork in front of you, and you do not need to have the answers. If you cannot name a medication, say so. The call is to establish whether this home can meet the need, and to tell you plainly if it cannot, which saves you a tour and a difficult month.

What to Have Within Reach

Nothing is required for the first conversation, but a few items make every conversation after it faster: the current medication list; the discharge summary from a recent hospital stay; the names of the primary care physician and any specialists; and the payment source, whether private funds, long-term care insurance, or Medicaid through Washington's Apple Health program. The AARP Caregiving Resource Center has checklists for organizing medical and legal paperwork.

Bring one thing that does not fit in a folder: your loved one's own preferences. Whether they sleep late, want the door open, or will not eat in a room full of people. Staff can learn a medication list in an afternoon. They can only build a good day around a person if someone tells them what that person's days have always looked like.

Questions Worth Asking Any Home You Tour

Start with the routine questions, then ask the ones that make a room go quiet. What is the monthly rate, and what causes it to change? How much notice would you give if your loved one's needs grew past what this home can serve? Who holds the license, and who is in charge when they are away? How are complaints handled?

Ask about staff turnover over the past year, and how the home documents medication errors. A home with a written process has thought about it; one that says it has never happened has not. Ask to review the inspection record, which every licensed adult family home in Washington has on file and you are entitled to read. The Department of Social and Health Services publishes how licensed homes are monitored and what a finding means. Then ask to see a sample care plan and a daily log, because real ones name specific tasks, times, and who performed them.

What the Assessment Involves

Washington uses a state assessment called CARE, short for Comprehensive Assessment Reporting Evaluation, to measure how much help a person needs with daily activities and nursing tasks. It sets the payment tier for Medicaid-funded care, and it is a useful map even for private pay, because it separates what a person can still do from what must be done for them.

Separately, a good home carries out its own nursing review before admission, walking through medications, skin, swallowing, mobility, and equipment. It is not a test your loved one can fail. It is how the care plan gets built, and it is meant to be repeated as things change, after a hospital stay, after a medication adjustment, or as a condition progresses. If the plan written on the first day is still the plan a year later, ask why.

Timing Your Search

Discharge dates move quickly, and a six-bed home has only six openings, so call as soon as you know a move might be needed, even before the date is confirmed. Asking early costs you nothing and keeps the option open.