This is the 20th in a series of articles discussing senior living alternatives.

Previous articles profiled retirement communities offering a wide range of options from independent living to assisted living and long-term care.

For people unable to live independently, another choice is a stand-alone facility that offers either assisted living or skilled nursing/nursing care. Costs vary, but appear to fall in a range similar to those of the retirement communities.

Stand-alone assisted living centers typically house about 50-100 people each. Two that offer dementia care in the Prescott, AZ area are the Margaret T. Morris Center and Highgate Senior Living. (Highgate also offers regular assisted living.)

In addition, 22 local assisted living homes house 5-10 people each.

Stand-alone skilled nursing/nursing facilities in the area house roughly 65 to 115 people each.

It is beyond the scope of this column to evaluate all stand-alone facilities. However, I can tell you what I would do if I were researching facilities for a relative.

First, identify the options. One source is the Arizona Department of Health and Human Services licensing website at PDF files (and other formats) separate sites into assisted living, long-term care, and so forth. Facilities are listed by zip code.

The assisted living list distinguishes between assisted living centers (licensed for more than 10 people) and assisted living homes (licensed for 5-10 people). It also separates out sites by license level: directed care, personal care, and supervisory care. Directed care is the highest level of licensing for assisted living in Arizona.

Second, look at the state inspection results for any facilities you consider. At, select Facility Search and then the type of care (assisted living, etc.) and search on the facility’s name.

Virtually every assisted living and skilled nursing/long-term care facility gets citations (notices of problems) as a result of inspections. The regulations are lengthy and complex, and perfection is hard to come by. The question to ask is whether the citations suggest that residents are at great risk.

For example, state law generally requires that health care workers have a test to prove that they are free of tuberculosis when they start work and once a year after that.

Suppose a new employee had the test six months earlier at another employer, and then got the test on Day 2 instead of on Day 1 with the current employer, and both tests showed that she did not have tuberculosis. Because she did not have the test Day 1, the facility is in violation of the law and may get a citation.

But it seems unlikely that residents were at great risk.

Now consider an example that might lead you to a different conclusion.

The state generally requires that employees involved in direct patient care have a fingerprint clearance card, which indicates that the state has concluded that they have not been convicted of homicide, sexual assault, and so forth.

If a facility gets a citation for continuing to employ a worker who has been denied a fingerprint clearance card, you might be concerned on two counts: first, might vulnerable residents be at risk? Second, if management violates this regulation, are they similarly lax about other important requirements? Inspectors may not discover every problem.

Third, after creating a short list of some facilities whose type, location and inspection records look acceptable to you, try to find their websites and read about them.

Fourth, visit the facilities in person, with checklists in hand so that you remember to ask questions important to you. One site that offers very detailed checklists about costs and contracts, personal care, quality of life, and so forth is under Checklists & Forms. Trust your senses and intuition during your visit.

Fifth, compare the sites that seem best -- on characteristics that are important to the prospective resident. I was reminded of this point when I described local retirement communities to an older relative in terms of apartment size, meal options, amenities and activities. She replied, “I don’t care about any of that. As long as I can get cheese and coffee, all I care about is having great internet access.”

The next two columns will discuss subsidized senior housing, which may be an excellent choice if money is quite limited.

-- Next -- 101. Subsidized Senior Housing: An Alternative to Retirement Communities