Opening the Conversation: The Story So Far

• Tell me briefly what happened that brought you to consider a senior living move now.
• Who is the parent or person we are discussing, and what's their current living arrangement? Options: Lives alone, Lives with spouse/partner, Lives with family, Residential care (assisted living/ memory care), Skilled nursing/rehab, Other
• When did you first notice a meaningful change in their ability to manage daily tasks? Options: Within the last week, Within 2-4 weeks, 1-3 months, More than 3 months, Not sure
• Describe the most recent hospital or clinic recommendation about their care.
• Which family members or paid caregivers are already helping day to day? Options: Adult child, Spouse, Private caregiver, Home health agency, Neighbor/friend, Geriatric care manager, Other
• Do you have a target timeline for making a placement decision? Options: Within 48 hours, Within 7 days, Within 2-4 weeks, Within 1-3 months, No timeline yet

Where Daily Care Really Breaks Down

• What is the single care gap that would make you move them out of the home this week?
• How often does the issue you named happen, and what typically triggers it? Options: Daily, Several times a week, Weekly, Less often, Unpredictable
• In the last 30 days, how many falls, ER visits, or medication errors have occurred? Options: None, 1, 2-3, 4 or more, Unsure
• Who handles medications, appointments, and dressing now, and how reliable are they? Options: Family member, reliable, Family member, unreliable, Paid caregiver, reliable, Paid caregiver, unreliable, No reliable caregiver
• Tell me about any behaviors related to memory or confusion that concern you.
• If the current caregiver stopped tomorrow, could you cover their responsibilities for more than two weeks? Options: Yes, No, Only short term, under 2 weeks, Unsure

Safety Signals to Watch Closely

• If a single safety issue could force an immediate move, which would it be? Options: Frequent falls, Wandering/exit-seeking, Severe medication errors, Inability to eat or hydrate, Aggressive behavior, Other
• Are there unsecured exits, wandering episodes, or repeated missed meals? Options: Yes, wandering/exits, Yes, missed meals, Yes, both, No, Unsure
• When the parent becomes disoriented, how do they usually respond? Options: Try to leave, Become anxious or agitated, Sleep it off, Call out for help, Unable to respond
• Which medical devices, oxygen, or mobility aids do they rely on daily? Options: Walker/cane, Wheelchair, Home oxygen, Feeding tube, None, Other
• How confident are you that the home can be modified to remove these risks? Options: Very confident, Somewhat confident, Not confident, Not sure
• Would you accept a placement with 24-hour supervision if it meant moving into a community outside your preferred neighborhood? Options: Yes, Maybe, depending on cost, Prefer closer even with less supervision, No

The Other Paths You're Considering

• Under what conditions would your current plan be acceptable so you do not move to a community? Options: Increased home health support, Guaranteed caregiver schedule, Medical stability for 3 months, Financial support secured, Other
• Select the options you are weighing right now. Options: Keep current home with more care, Increase private home care, Move in with family, Independent living, Assisted living, Memory care, Short-term rehab/skilled nursing, Hospice, Other
• Have you asked any communities to hold a bed or provided pre-admission deposits? Options: Yes, hold requested, Yes, deposit paid, No, not yet, Unsure
• List the communities or referral sources you've spoken with and a one-line impression for each.
• Share the single measurable assurance that would make you keep the current provider, for example staffing levels or inspection record.
• Identify the single barrier that would prevent you from committing immediately after a successful short trial with a community. Options: Cost, Distance, Lack of required care services, Family objection, Unresolved medical records, Other

Money Matters: What You Can and Can't Take On

• What's the maximum monthly cost you can realistically consider? Options: Under $3,000, $3,000–$5,000, $5,000–$7,000, $7,000–$10,000, Over $10,000, Unsure
• Select the payment sources you expect to use. Options: Personal savings, Family contributions, Long-term care insurance, Medicaid, VA benefits, Private health insurance, Other
• Estimate the assets or monthly income available to cover care over the next 12 months.
• Name the person with financial authority and their relationship to the parent.
• Have you checked whether long-term care insurance or VA benefits require prior authorization, residency periods, or exclusions? Options: Yes, verified coverage, Partially verified, Not verified yet, Not applicable
• Would you stop the placement if monthly costs exceeded your maximum by $1,000, or would you adjust the plan? Options: Stop placement, Adjust budget elsewhere, Negotiate care level, Unsure

Who Decides and How Fast We Must Move

• Name the person whose objection alone would stop placement, and explain their main concern.
• Do any family members live locally and could manage visits or move coordination? Options: Yes, one local family member, Yes, several local members, No local family, Paid local caregiver available, Other
• Choose the timeframe that matches your target for moving the parent. Options: Within 48 hours, Within 7 days, Within 2-4 weeks, Within 1-3 months, No firm timeline
• Describe any family disagreements or past conflicts that could delay choosing a community.
• Are there any legal holds, conservatorship actions, or court matters that affect who can decide? Options: Power of attorney in place for health, Power of attorney for finances, Court conservatorship, No legal authority established, Unsure
• Could you proceed without a specific family member's approval if power of attorney allows it? Options: Yes, No, Only with mediation, Unsure

Medical Records, Providers, and Practical Readiness

• Could you provide complete medical records within 48 hours if a community requested them? Options: Yes, Yes with help from providers, No, would take longer, Unsure
• Choose the providers we should contact for records. Options: Primary care, Cardiologist, Neurologist, Psychiatrist, Home health agency, Hospital records, Pharmacy, Other
• Identify the person authorized to sign release forms and their relationship to the parent.
• List any outstanding medical tests, pending prescriptions, or equipment orders that could delay admission.
• Is the medication list consistent across providers and the most recent hospital discharge summary? Options: Yes, consistent, Some differences, Major discrepancies, I do not know
• Pick the likely outcome if a critical record is missing at admission. Options: Admission delayed, Provisional admission with monitoring, Community refuses admission, Alternative documentation accepted, Unsure

Deciding the Next Steps Together

• Estimate how much meeting a clear safety goal within two weeks would accelerate your decision. Options: Would sign within a week, Would sign within two weeks, Might accelerate by a month, Not likely to change timing, Unsure
• Pick the next three actions you want us to take to move this forward. Options: Arrange virtual assessment, Book community tours, Obtain medical records, Speak with primary care, Estimate costs and fees, Hold a bed, Connect with insurer, Other
• Provide the primary owner for move coordination on your side and the best way to reach them.
• By what date do you need someone moved to avoid an emergency hospitalization, if any? Options: Within 48 hours, Within 7 days, Within 2-4 weeks, No urgent date, Unsure
• Indicate any non-negotiable preferences about community features. Options: Memory care specialized staff, Private room required, Near hospital, Pet friendly, Religious services, Skilled nursing onsite, Outdoor space, Budget limit, Other
• State the one barrier that would make you pause or stop the placement search this week. Options: Cost, Unresolved medical records, Family objection, No available beds, Need more time to evaluate, Other

• Placement Plan Review Session

• You confirm the prioritized placement plan aligns with the parent's clinical needs, safety risks, and the family's budget ceiling.
• Confirm the current state and its cost
• Provide the finalized prioritized placement plan, including three recommended community scenarios, line-item projected costs, and documented trade-offs within 48 hours.
• You accept a ranked short list of recommended community scenarios or provide specific objections that must be addressed before proceeding.
• Prepare and propose two dates for escorted tours of the top recommended communities within five business days.
• Present the prioritized placement plan
• Confirm final decision-makers, the family's monthly budget ceiling, and any absolute non-negotiable care requirements within 24 hours.
• Compare likely costs and trade-offs
• You agree the next-step timeline and the clear deliverable that will lead to placement within the stated decision window.
• Review recommended community scenarios
• Share the parent's latest medical summary and any power of attorney or payment authorization documents if not already provided.
• Validate the plan with the family constraints
• Agree next steps, timeline, and owners

• Placement Plan Review Session
• Placement Plan Review Deck
• Placement Plan Solution Brief

• meeting
• slides
• document

• Deliver pre-screened community dossiers
• Accompany family on in-person community tours
• Host guided virtual community tours
• Verify community licensing and inspection records
• Negotiate move-in fees and contract terms
• Set up community billing and payment arrangements
• Transfer medical records and medication lists
• Secure short-term respite or rehabilitation placement
• Provide move-in day on-site support
• Assemble resident welcome and care-preference packet
• Provide 30-day post-move on-site check-in visit
• Assist with benefits and insurance intake documentation

Deliver pre-screened community dossiers

• Which care settings should each dossier cover (assisted living, memory care, skilled nursing, rehab)? Options: Assisted living, Memory care, Skilled nursing, Rehabilitation / short-term rehab
• Which dossier elements are required for your decision (staffing ratios, most recent state inspection date, incident summary, sample monthly bill, contract highlights)? Options: Staffing ratios, Most recent state inspection date, Incident summary / complaints, Sample monthly bill and fee schedule, Contract highlights and termination policy
• How many community dossiers do you want included on the shortlist per placement candidate? Options: 3, 5, 7, Other (describe)
• When should an on-site visit report be considered current (e.g., within the last 90 days)? Options: Within 30 days, Within 90 days, Within 180 days, No limit
• Are there financial artifacts you require in every dossier (move-in fee invoice, refundable deposit terms, copy of typical monthly statement)? Options: Move-in fee schedule, Refundable deposit terms, Typical monthly statement, None required
• Which nonclinical quality signals should be highlighted in the dossier (resident satisfaction survey, activity calendar, dining sample menus)? Options: Resident satisfaction summary, Activity calendar, Sample menu, Staff turnover notes
• What defines an acceptable dossier for sign-off (e.g., includes state inspection report and a dated on-site visit within X months)?

Accompany family on in-person community tours

• Will you require an advisor to physically join the in-person tours? Options: Yes, advisor must attend, No, family will attend alone, Occasionally, on request
• Who will be responsible for scheduling the tour appointments with the community? Options: You / family, Community staff, Advisor coordinates, Shared responsibility
• How many in-person tours do you expect per candidate resident during the evaluation phase? Options: 1, 2, 3+, Undecided
• Will you want the advisor to use a structured tour checklist that inspects staff interactions, dining service, and room readiness? Options: Yes, No
• Which accessibility or transport needs should be arranged for tours (wheelchair-access van, stretcher-capable vehicle, aide accompaniment)? Options: Wheelchair-access van, Stretcher-capable vehicle, Aide accompaniment, No special transport
• Are there specific days or time windows when in-person tours are not allowed (visiting hours, mealtimes)? Options: Weekday mornings, Weekday afternoons, Evenings/weekends, Flexible

Host guided virtual community tours

• Which virtual format do you prefer for guided tours? Options: Live video call with staff Q&A, Pre-recorded walkthrough with notes, Live-stream only (no Q&A), Phone briefing only
• Will you require the virtual tour to include a live Q&A with nursing or the community director? Options: Yes, No
• How long should the guided virtual tour be to cover clinical spaces, dining, and resident areas? Options: 20 minutes, 30 minutes, 45 minutes, 60 minutes
• Do you want captioning or live interpretation services during the virtual tour? Options: Captioning, Live interpretation, Neither
• Will you require a recorded copy of the virtual tour and an annotated summary afterward? Options: Recorded copy and summary, Recorded copy only, Summary only, Neither
• Which follow-up deliverable would help compare virtual tours (side-by-side rate table, care-capability matrix, photo set)? Options: Rate comparison table, Care-capability matrix, Photo set, All of the above

Verify community licensing and inspection records

• Which license types must be confirmed for each candidate community (state assisted living license, memory care designation, skilled nursing license)? Options: State assisted living license, Memory care designation, Skilled nursing / nursing facility license
• How far back should inspection and citation history be reviewed (12, 24, 36 months)? Options: 12 months, 24 months, 36 months, No preference
• Are you requiring documented evidence that any cited deficiencies have approved corrective action plans? Options: Yes, No
• Who should be the contact for obtaining state inspection reports if additional records are needed? Options: You / family, Community administrator, Advisor requests on behalf
• Will criminal background and staff vaccination verification be required as part of the verification packet? Options: Criminal background checks, Staff vaccination summaries, Both, Neither
• What documents will validate license and inspection compliance (for example, state inspection report PDF, citation resolution letter, or dated corrective action plan)?

Negotiate move-in fees and contract terms

• Which contract elements require negotiation prior to placement (monthly rate, included services, termination clause, bed-hold policy)? Options: Monthly rate, Included services / care levels, Termination clause, Bed-hold policy, Refundable deposit
• Will you request a negotiated reduction in the move-in fee or a payment plan for move-in costs? Options: Request reduction, Request payment plan, No negotiation
• Who is authorized to approve contract exceptions on your behalf (named family member, power of attorney, conservator)? Options: Named family member, Power of attorney, Conservator, Undecided
• Is a trial or respite clause required in the contract to allow a short-term evaluation period? Options: Yes, trial/respite clause required, No trial clause required
• Which payment methods and schedules are acceptable for you (monthly invoice, ACH auto-draft, credit card with surcharge)? Options: Monthly invoice, ACH / bank draft, Credit card, Other
• List any nonstandard contract clauses you require reviewed (e.g., guaranteed staffing ratio, return-of-deposit timeline).

Set up community billing and payment arrangements

• Which payer sources will cover residency and services (private pay, Medicaid, Medicare, long-term care insurance, VA benefits)? Options: Private pay, Medicaid, Medicare, Long-term care insurance, VA benefits
• Will you require a completed billing authorization or payment agreement before move-in? Options: Yes, No
• Which billing cadence do you prefer for resident invoices? Options: Monthly, Bi-weekly, Quarterly, Custom
• Do third-party payers or a representative (power of attorney) need to be added to billing as authorized payers? Options: Yes, No
• Will you require automatic payment setup such as ACH bank draft? Options: Yes, No
• What documents do you expect to provide for benefits verification and billing setup (proof of income, insurance policy, Medicare/Medicaid ID)?

Transfer medical records and medication lists

• Which clinical documents must be transferred to the community prior to move-in (discharge summary, current medication administration record MAR, physician orders, advance directives)? Options: Hospital discharge summary, Current MAR, Physician orders, Advance directives / POLST
• Which transfer method do you require for medical records (secure portal upload, encrypted email, fax with confirmation, paper copy)? Options: Secure portal upload, Encrypted email, Fax with confirmation, Paper copy delivered
• Who will sign release of information (ROI) forms for medical record transfer (resident, power of attorney, legal guardian)? Options: Resident, Power of attorney, Legal guardian, Other
• How soon must the community confirm receipt of the core clinical packet before move-in (24 hours, 72 hours, 7 days)? Options: 24 hours, 72 hours, 7 days
• Are medication reconciliation and a verified MAR handover required on move-in day? Options: Yes, No
• What evidence will confirm successful medical-record transfer (for example, community EHR receipt acknowledgment or uploaded MAR screenshot)?

Secure short-term respite or rehabilitation placement

• What is the anticipated duration of the respite or rehab placement you require? Options: Less than 1 week, 1-2 weeks, 2-4 weeks, More than 4 weeks
• Which level of care is needed for the short-term placement (assisted living respite, memory care respite, skilled nursing rehab)? Options: Assisted living respite, Memory care respite, Skilled nursing / rehab
• Do you require guaranteed bed-hold for transition from respite to long-term placement? Options: Yes, No
• Will therapy services be required during the stay (physical therapy, occupational therapy, speech therapy)? Options: Physical therapy (PT), Occupational therapy (OT), Speech therapy (SLP), None
• Is prior insurance authorization required for the rehab/respite stay? Options: Yes, No, Unsure
• Who will coordinate discharge from the short-term placement back to the community or home (hospital case manager, advisor, community discharge planner)? Options: Hospital case manager, Advisor, Community discharge planner, Family

Provide move-in day on-site support

• Which move-in tasks should the advisor perform on-site (supervise admission paperwork, coordinate transport, oversee room set-up, medication handover)? Options: Supervise admission paperwork, Coordinate transport, Oversee room set-up, Medication handover
• What time window do you expect for move-in day support (morning, afternoon, full-day)? Options: Morning (8am-12pm), Afternoon (12pm-5pm), Full-day coverage
• Will you require assistance with furniture assembly or personal-item inventory tagging on move-in day? Options: Yes, No
• Are there medical equipment installations needed at move-in (hospital bed, Hoyer lift, oxygen concentrator)? Options: Hospital bed, Hoyer / lift, Oxygen equipment, None
• Who should be listed as the on-site owner for move-day issues (family representative, power of attorney, advisor)? Options: Family representative, Power of attorney, Advisor, Community contact
• Will you require a signed medication reconciliation on the community MAR at the end of move-in day? Options: Yes, No

Assemble resident welcome and care-preference packet

• Which items must be included in the welcome packet (emergency contacts, daily routine, dietary restrictions, toileting schedule, calming strategies)? Options: Emergency contacts, Daily routine preferences, Dietary restrictions, Toileting schedule, Behavioral triggers and calming strategies
• Should the packet include a one-page clinical summary for nursing (ADL baseline, allergies, primary diagnoses)? Options: Yes, No
• Will you provide a family-supplied personal-items list and favorite activities to include in the packet? Options: Yes, No
• Do you require the packet to include signed consent forms such as permission to photograph or activity release? Options: Yes, No
• In which formats should the packet be delivered to the community (printed folder, digital PDF upload to community portal)? Options: Printed folder, Digital PDF upload, Both

• Mutual Placement Agreement
• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Placement Fee Schedule and Order Form
• Payment Authorization & Deposit Receipt
• Authorization to Act as Agent
• Medical Records Release
• Move Coordination Addendum
• Cancellation and Termination Agreement
• HIPAA Business Associate Addendum (BAA)
• Privacy and Data Processing Addendum

• Post-Move Go-Live Health Check
• First Measurement Review (end of onboarding window)
• Acceptance Gate Decision (end of onboarding window)
• Quarterly Post-Move Review

• Run a billing audit for moves completed in the last quarter and report any discrepancies within 10 business days.
• Assign remediation tasks for each unresolved care issue with resolution dates and expected verification steps.
• Schedule a focused medication review or care-plan adjustment when family satisfaction is below the agreed target.
• Complete outstanding medical record transfers and confirm receipt by the community within 5 business days.
• Restate acceptance criteria and numeric targets from Mutual Placement Agreement
• Produce a documented acceptance decision by the buying owner comparing outcomes to the Mutual Placement Agreement targets.
• List any failed acceptance criteria with remediation plans and hard deadlines.
• Confirm the recurring schedule for ongoing reviews and the shared communication channel for continued support.
• Publish the acceptance decision and the acceptance matrix comparing each outcome to its target recorded in the Mutual Placement Agreement stage.
• Create remediation tickets for each failed criterion with resolution deadlines and verification steps.
• Confirm recurring calendar invites for the ongoing review cadence and provide access details for the shared communication channel.
• Review rolling family satisfaction score and trend
• Confirm the rolling family satisfaction score remains at or above the target or record corrective actions if below target.
• Confirm care incident rate per resident is stable or improving and document mitigation plans for any increases.
• Ensure all remediation items from prior meetings are tracked with updated statuses and next steps.
• Update and publish care plan adjustments to the shared channel with completion dates and verification steps.
• Close resolved items in the open issues log and escalate any overdue remediation tickets for immediate attention.
• Re-confirm agreed success signals and owners
• All critical safety and care-handover tasks are confirmed complete or have a named remediation with a due date.
• Medical record transfer and medication reconciliation status documented with owners and target completion dates.
• Shared communication channel created and acknowledged by family and community contacts.
• Document and publish the list of open move-day issues with owners and due dates.
• Complete medication reconciliation and confirm the final medication list with the community nurse within 48 hours.
• Complete billing account setup or provide an interim billing plan within 7 days.
• Present outcome data against key metrics
• Determine whether the number of unresolved care issues at 30 days falls within the tolerance discussed during placement and document any excess items.
• Confirm the family satisfaction score at 30 days and whether remediation is required if below target.
• Agree a concrete remediation plan with dates for any outstanding medical record transfers and unresolved care items.
• Present outcome data against each criterion
• Review rate and severity of care incidents this quarter
• Verify room readiness and care handover
• Review care delivery and any escalations
• Document pass or fail per acceptance criterion
• Medical record and medication reconciliation status
• Open issues log and remediation progress
• Root cause analysis for gaps
• Record acceptance decision and remediation commitments
• Billing setup and payment enrollment status
• Agree corrective actions and timeline to acceptance gate
• Financial and billing status review
• Confirm readiness for the acceptance gate
• Agree care-plan adjustments and next actions
• Open issues, immediate remediation actions, and owners
• Confirm transition to ongoing support cadence
• Confirm shared communication channel and next check-in