To Our Valued Clients and Friends.

After 10 years of service, we have decided to cease operations.

We are thankful to our guests, staff, associates, and colleagues for their

exemplary and steadfast support and efforts over all these years.


Through our tenure, we've learned a number of insights and developed recommendations. Below, we share just a few that we hope are valuable.
Feel free to use with attribution.



Copyright 2017 by Stephen Streib, all rights reserved.




  • For your first visit to any community, do not make an appointment! Just show up. You want to know what the community is like on an everyday basis, not after they have spent 2 hours cleaning up for your visit.
  • The best time to visit is at lunch time. You get to see all of the residents and how they interact with the staff and each other. This allows you to make a better determination as to suitability and compatibility.
  • You also get to see what they ACTUALLY serve on a day to day basis. Are there fruit and salads available or is it a one dish low cost canned food menu?
  • Everyone is interested in getting the most value for their dollar. But all communities are not equal. One major difference is whether or not they have awake staff at night. A survey that I performed at the beginning of 2014 (I called 100 six bed communities) indicated only one out of ten small communities had awake night staff. This of course increases payroll by about 35%. An awake staff at night allows that staff to prepare the food for serving the next day, do laundry, vacuuming, cleaning, etc. This means the daytime staff can spend more time and focus on caring for residents rather than spending the 6-7 hours it takes to prepare three nutritious meals from scratch and the housekeeping.


  • As you arrive at the residence, do you like its location and outward appearance?
  • As you enter and tour the residence, is the decor attractive and home-like?
  • Does the administrator/staff call residents by name and interact warmly as you tour?
  • Do residents socialize with each other and appear happy and comfortable?
  • Are you able to talk with residents about how they like the residence and staff?
  • Do the residents seem to be appropriate house mates for you or your loved one?
  • During your tour are the staff members friendly to you?
  • Are visits with the residents welcome at any time?


  • Is the community well designed for resident’s needs?
  • Are the outside grounds neat and well kept?
  • Is there space and areas to enjoy the outside or is the focus mostly inside the residence.
  • Are there safe areas to walk and enjoy the grounds?
  • Are handrails available to aid in walking where needed?
  • Are floors of a nonskid material and carpets firm to ease walking?
  • Is the residence clean, free of odors, and appropriately heated/cooled?
  • Does the residence meet local and/or state licensing requirements?
  • Does the residence have a means of security if a resident wanders?


  • Does the residence have specific policies regarding storage of medication, assistance with medications, training, and supervision of staff and record keeping?
  • Is self-administration of medication allowed?
  • Is there a staff person to coordinate home care visits from a nurse, physical therapist, occupational therapist, etc. if needed?
  • Is staff available to assist residents who experience memory, orientation, judgment losses?
  • Does the residence have a clearly stated procedure for responding to a medical emergency?
  • To what extent are medical services available and how are these services provided.


  • Do dining room menus vary from day to day and meal to meal?
  • Are different sized and types of rooms available?
  • Are rooms for single and double occupancy available?
  • Is a 24-hour emergency response system accessible from the unit?
  • Are bathrooms private or semi-private and with handicapped accommodations?
  • Do units have a telephone and cable TV and how is billing handled?
  • May residents keep food in their rooms?
  • May residents smoke in their rooms? In public spaces? (No Smoking at BVR)


  • Can the residence provide a list of services available?
  • Is staff available to provide 24-hour assistance with activities of daily living (ADL’s) if needed? ADL’s include; dressing; eating; mobility; hygiene and grooming; bathing; toileting and incontinence; using the telephone; shopping; and laundry.
  • Does the residence provide housekeeping services in resident’s rooms?
  • Do they provide transportation to doctor’s offices and other activities desired by residents?
  • Can residents arrange for transportation on fairly short notice?
  • Are pharmacy, barber/beautician, and/or physical therapy services offered on-site?


  • Is there evidence of an organized activities program, such as events in progress, reading materials, visitors, etc.?
  • Do residents participate in activities outside of the residence in the neighboring community?
  • Do volunteers, including family members, come into the residence to help with programs?
  • Does the residence create a sense of community by requiring residents to participate in certain activities or perform simple chores for the group as a whole?
  • Are resident’s pets allowed in the residence? Who is responsible for their care?


  • Does the residence provide three nutritionally balanced meals a day? Seven days a week?
  • Are snacks available?
  • May a resident request special food?
  • Are common dining areas available?
  • May residents eat meals in their rooms?
  • May meals be provided at a time a resident would like or is there set times for meals?


  • Is a contractual agreement available that discloses healthcare and supportive services, all fees, as well as admission and discharge provisions?
  • Is a contractual agreement available to include accommodation, personal care, health care, and supportive services?
  • Does the residence have a process for assessing a potential resident’s need for services and are those needs addressed periodically?
  • When may a contract be terminated and what are refund policies?
  • Are additional services available if the resident’s needs change?
  • Is there a procedure to pay for additional services when temporary services are needed?
  • Are there different costs for various levels or categories of services?
  • Do billing, payment, and credit policies seem fair and reasonable?
  • May a resident handle his or her own finances with staff assistance if able or should a family member or outside party be designated to do so?
  • Is staff available to meet scheduled and unscheduled needs?
  • When may a contract be terminated? What are the policies for refunds and transfers?
  • Is there an appeals process for dissatisfied residents?

Copyright 2017 by Stephen Streib, all rights reserved.