What to ask a facility about money, before you sign anything

Ask for three documents before you go on any tour

Phone ahead and ask them to email these three things. If they will not send them before a visit, write that down — it tells you something, and you will want the note when you compare places later.

One: the current fee schedule, the full price list, not the starting-from figure. Two: a blank copy of the residency agreement, unsigned, to take away and read at home. Three: the most recent state inspection or survey report, or the web address where it is published.

Read the fee schedule before the tour and mark anything you do not understand. Take the marked-up copy with you and ask about each mark while you are standing in the building. It is a different conversation when you have the numbers in your hand.

If what arrives is a glossy brochure with one price on it, ring back and ask specifically for the itemised schedule with the care-level pricing. That is a real document and every facility has one.

The base rate, and everything that sits outside it

The single most useful question on a tour is: "Which of these is inside the base rate, and which is billed on top?" Then go down the list and get a yes or no for each one.

Write the answers on the fee schedule itself, with the date and the name of the person who told you. If they say "it depends on the level," that is not an answer — ask what the level costs at each step and ask to see the schedule that sets the steps.

Ask for one more thing before you leave: a sample invoice from a current resident with the name removed. Some facilities will provide one, some will not. A real invoice shows you in thirty seconds what a tour cannot.

• The community fee or entry fee — how much, and is any of it refundable?
• Laundry — personal laundry as well as bed linen?
• Help with medications — is there a separate monthly fee, and does it change by number of doses?
• Being walked to meals, or help at the table
• Help that needs two members of staff rather than one
• Incontinence supplies — supplied, or billed, or brought in by the family?
• Wifi, cable and a phone line
• Transport to appointments — included, per trip, or only on certain days?
• Hairdressing and personal care
• Guest meals, and whether a family member can eat there
• A second person sharing the room
• Anything charged when your parent is in hospital and the room is held

The increase questions, asked in numbers

Do not ask "do prices go up?" Everyone says yes, roughly, once a year. Ask for the arithmetic instead.

Ask: "What was the percentage increase in each of the last three years?" Then ask them to put those three numbers in an email. A facility that will not put three historical numbers in writing has told you something useful.

Then ask about the other kind of increase, which catches people out more often: the move from one care level to the next. Ask who decides that a resident has moved up a level, what they use to decide it, whether you can see that scoring sheet blank, how much notice you get before the higher rate starts, and whether it can be appealed and to whom.

Ask what happens to the rate when your parent's needs go down again. Some agreements move up and never down, which is a fair arrangement if you know about it in advance and a nasty surprise if you do not.

Write every answer with a name attached. "Sandra, 12 May, said levels are reviewed quarterly by the wellness director" is a note you can hold up later.

The leaving questions, asked before you arrive

Ask these on the first visit, when they are easy to ask. They become much harder to ask once your parent has moved in.

Get the notice period in writing on both sides — what you must give, and what they must give you. Ask what circumstances allow the facility to end the agreement, and how much notice you would get. Ask what happens to the deposit and how long the refund takes.

Ask the money-runs-out question plainly, because nobody volunteers it: "If a resident's private funds run out, what happens? Does this facility accept Medicaid residents, in which units, and is there a minimum period of private payment first?" Write the answer word for word. Ask them to confirm it in an email.

Ask what happens if your parent needs more help than this facility provides — who decides that, what notice is given, and whether they help with the move.

Ask what happens to the room, and to the billing, during a hospital stay.

The contract: what to have read before you sign

The residency agreement is a contract, and reading contracts is a profession. Yours is not it, and neither is mine.

Take the blank agreement home. Do not sign anything in the building on the day, however reasonable the pressure feels. Have an attorney read it before you sign — a single hour of a lawyer's time against a multi-year commitment is not a close call.

There is one question to ask the administrator yourself, and it matters: "Show me every line I am being asked to sign, and tell me in what capacity I am signing each one." Then take that page to the attorney and ask specifically about it. Do not sign anything that describes you personally in any capacity until someone qualified has explained that page to you.

Ask which documents form part of the agreement — the fee schedule, the house rules, any handbook — and ask for a copy of each one that is referenced. Attachments referenced but not supplied are the most common gap.

Keep the signed copy, the fee schedule current at the date of signing, and every subsequent rate letter in one folder, in date order.

Compare on one sheet, or you will not compare at all

After the third tour they blur. Build one comparison sheet before you visit anywhere, and fill it in in the car park immediately afterwards, not that evening.

One column per facility, one row per question. At minimum: base rate, care level rates, community fee, the twelve add-ons, last three increases, notice period on both sides, the money-runs-out answer, staffing at the times you asked about, distance from your house in real driving minutes at 5pm, and the name and direct number of the person who gave you the answers.

Add two rows that are not about money and are the ones you will actually re-read: what it smelled like, and what the residents were doing when you walked in.

Photograph the fee schedule and the corridor. Staple your notes to the printed schedule. Put the whole comparison in one folder and email a copy to every sibling the same week — this is the single document that most reliably ends a long-running family argument, because it replaces opinions with a grid.

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