Questions to Ask Before Moving a Parent to a Care Facility in Oregon

Before the Tour: What to Request in Advance

Ask for two documents before you schedule a visit: the facility's Consumer Summary Statement (required under SB 815) and a sample admission agreement. Reviewing these documents at home, without the pressure of a sales presentation, gives you a baseline understanding of what the facility actually offers versus what their marketing implies.

The Consumer Summary Statement is a standardized disclosure that every Oregon community-based care facility must provide to prospective residents. It lists the specific services the facility is licensed and staffed to deliver, and — critically — the clinical thresholds that would trigger an involuntary relocation to a higher level of care.

Questions About Care and Staffing

"What is your staff-to-resident ratio during day, evening, and overnight shifts?" Ratios change dramatically by shift. The daytime ratio might be reasonable while the overnight ratio drops to a single caregiver for an entire wing. If your parent needs help with nighttime toileting or is at risk of nighttime falls, the overnight ratio matters as much as the daytime one.

"Are your caregivers employed by the facility or contracted through a staffing agency?" Facilities that rely heavily on agency staff have higher turnover. Consistent caregivers learn your parent's routines, preferences, and early warning signs — agency staff cycling through may not recognize when something is wrong.

"What triggers a reassessment of my parent's care tier, and how much notice will we get before a rate increase?" Oregon ALFs and RCFs use tiered pricing based on care needs. When your parent's condition changes, the facility can reassess and move them to a higher (more expensive) tier. Ask for the specific tier structure in writing — how many tiers, what each costs, and what functional criteria push someone from one tier to the next.

"Do you hold a Memory Care Community endorsement?" If your parent has dementia or is at risk of wandering, verify this directly. Oregon doesn't issue standalone memory care licenses — the facility must hold a specialized endorsement under OAR 411-057. Facilities sometimes market "memory care wings" without holding the endorsement, meaning they lack the secured perimeters and specialized staffing ratios the endorsement requires.

Questions About Costs and Billing

"What is the base monthly rate, and what services are billed separately?" Get this in writing. Common additions billed beyond the base rate: medication management, incontinence supplies, specialized diets, escort to on-site activities, and laundry service. These add-ons can push the effective monthly cost well above the quoted base rate.

"Do you accept Medicaid, and if so, do you have Medicaid-certified beds available?" Not all Oregon ALFs and RCFs accept Medicaid, and those that do often maintain a limited number of Medicaid-certified rooms. If your parent will eventually need Medicaid to pay for care, confirming bed availability now prevents a forced relocation later when private funds run out.

"What happens to the rate if my parent transitions from private-pay to Medicaid?" Some facilities require a minimum private-pay period (6–24 months) before accepting Medicaid. Others accept Medicaid from day one but may assign Medicaid residents to less desirable rooms. Get the policy in writing before signing.

Questions About Discharge and Transfers

"Under what circumstances would you involuntarily discharge my parent?" For an assisted living or residential care facility, Oregon law restricts involuntary discharge to six legally defined reasons: the facility can no longer meet care needs, the resident poses a safety threat, nonpayment after proper notice, facility closure, the resident no longer needs the services, or a physician/court order. The facility cannot discharge a resident simply because they transitioned to Medicaid or because the family filed a complaint.

"What is your discharge notice process?" For an assisted living or residential care facility, Oregon requires a written 30-day notice to the resident, their health care representative, and the local APD office. The notice must include a transition care plan and inform the resident of their right to appeal. If a facility gives you a verbal "we think it's time for your parent to move" without this formal process, they're not following the law.

"What clinical changes would exceed your facility's licensed capacity?" This is the practical version of the involuntary discharge question. Every facility has limits — most ALFs can't manage wound vacs, IV medications, or ventilators. Understanding these boundaries in advance helps you plan for the next transition before it becomes a crisis.

Questions About Daily Life

"Can I see the activity calendar for this month?" A printed calendar is more revealing than a verbal description. Look for variety and frequency. A facility that lists "bingo" three times a week and nothing else is offering a very different experience than one with gardening clubs, art therapy, live music, and community outings.

"Can my parent keep their own furniture in their room?" Personalization matters for cognitive health and emotional well-being. Some facilities allow personal furniture; others restrict it to photos and small personal items.

"What's your visitor policy, including evening and weekend hours?" Oregon's Bill of Rights under OAR 411 guarantees residents the right to receive visitors. If a facility imposes restrictive visiting hours, ask why and whether exceptions are made for family members who work during standard hours.

For a structured evaluation checklist that covers all of these questions alongside Oregon's Medicaid eligibility rules and care-level criteria, the Oregon Care Decision Guide provides a complete placement framework.

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