Evaluating Staffing and Turnover Before You Move In

Why this is hard to see from a tour

Unlike nursing homes, which report staffing hours to CMS as part of their federal star rating, assisted living communities in California only have to keep “sufficient staff” on hand — a standard, not a number. A tour during a well-staffed weekday afternoon can look very different from a Tuesday overnight shift. The senior-living industry has also been dealing with a genuine, well-documented staffing crisis: national direct-care turnover has stayed above 40% for years, and the large majority of operators report ongoing difficulty recruiting.

What to ask

• What’s the caregiver-to-resident ratio on the overnight shift, specifically — not the daytime number?
• How long has the administrator been in this role? How long has the core caregiving staff been here?
• Do you use agency (temp) staff regularly, or mostly employees who work here full-time?
• How quickly is a call button or call light answered — and how do you actually measure that, versus just estimate it?
• What happens when someone calls in sick? Is there a backup plan, or does the shift just run short?

Signs worth noticing on the visit itself

• Call lights or call buttons going unanswered for more than a few minutes while you’re there.
• Staff who seem rushed, or residents who mention long waits for help.
• A high number of unfamiliar faces on staff badges, or staff who don’t know residents by name.
• Visit more than once, at a different time of day — a second, unannounced visit tells you more than the scheduled tour.