The facility tour checklist — what to look at, ask, and notice

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

Walking into a rehab facility for the first time, you're operating on maybe three hours of sleep and a lot of adrenaline. Your parent is being wheeled in on a stretcher. Everything moves fast. Forms appear. You sign things. A nurse gives you a tour. And somewhere in the blur, you're supposed to be evaluating whether this is a good place for your parent to recover. The truth is, most of us aren't absorbing much of anything on that first visit. We're in survival mode. We're thinking about hospital discharge paperwork and whether we remembered to call work and whether our parent is scared.

But the facility tour matters more than you might realize in that first bewildered moment. Not because you're going to catch every problem on day one, but because you're establishing a baseline understanding of what this place looks like, where things are, who the staff are, and what kind of environment your parent is entering. You're also starting to build the relationships and ask the questions that will matter over the coming weeks.

This isn't about getting a facility owner to admit to anything sinister. Most facilities are doing legitimate work within real constraints of staffing, funding, and regulation. But what you learn on this tour shapes how you'll monitor care, what you'll advocate for, and whether you'll trust what staff tell you as recovery progresses. Pay attention, even if paying attention feels impossible right now.

What Actually Happens in Rehab

Before you even schedule a tour, understand what rehabilitation is supposed to accomplish. Your parent is here to regain function after an acute medical event. The specifics depend on what happened to them. If they had hip surgery, physical therapists are teaching them to walk again. If they had a stroke, occupational therapists are working on the small motor skills needed to button a shirt or feed themselves. If they're recovering from a serious infection or cardiac event, they're being monitored to ensure no complications develop while they rebuild strength.

This work is real work. Your parent will be tired. They'll be frustrated. Some days they'll make visible progress. Other days they'll struggle with the same task they managed yesterday. This isn't linear improvement. It's messy and nonlinear and full of setbacks. On your tour, watch the therapy spaces. See if therapists are actually engaging with patients or if people are sitting idle in wheelchairs. Ask how many therapy sessions your parent will receive per week. Ask whether the same therapist will work with your parent regularly or if the assignment changes. Consistency matters because a therapist who knows your parent's baseline can push appropriately.

The timeline for rehab is typically short. Insurance doesn't pay for indefinite stays. If your parent has Medicare, they're typically in rehab for three weeks, sometimes six if complications delay progress. If your parent has private insurance or is paying out of pocket, the timeline depends on cost and progress. If they're on Medicaid, they might have a longer stay. During this window, progress isn't about returning to baseline. It's about achieving the maximum functional improvement in the shortest time so your parent can be discharged to the safest possible situation.

This matters because sometimes that maximum functional improvement still means significant limitation. A stroke survivor might relearn enough basic self-care to go to a group home or adult day program, but they might not return to their previous level of independence. This is the reality that nobody really wants to say clearly in the first week, but it shapes everything. Your parent's doctor and therapists have a sense of what recovery looks like, but they won't always be clear about it because the future is genuinely uncertain.

Managing Expectations

Here's what you need to ask: "What would successful discharge look like for my parent?" The answer tells you what the facility thinks is realistically possible. If they say, "We're working toward her returning to her apartment independently," that's one expectation. If they say, "We're aiming for her to be safe enough for assisted living with part-time help," that's a different expectation. If they say, "We're maximizing her quality of life and function so she can move to long-term care safely," that's yet another. The right answer isn't "she goes home completely independent." The right answer is the honest answer.

Watching how function returns is part of managing your expectations. In the first week after hip surgery, your parent probably can't put weight on their leg at all. By week three or four, they might be walking with a walker and supervision. By week six, maybe with a cane. Some people eventually walk without an assistive device. Some people plateau with a walker forever. Some people never get back to independent walking and transition to long-term care. All of these outcomes are present at the beginning, and rehab staff have some sense of which is most likely for your parent based on their age, overall health, motivation, and medical complexity.

One of the hard truths: your parent's attitude and effort genuinely matter. You can't rehab someone who doesn't want to rehab. A person who shows up to therapy and pushes, even when it's uncomfortable, makes more progress than someone who goes through the motions. On your tour, ask whether the facility has experience with motivation issues. Ask what they do when a patient doesn't want to participate in therapy. Some facilities are better at this than others. Some will adjust goals downward if a patient isn't cooperating. Others will find ways to make the work feel less like work.

The other hard truth: progress plateaus. There's a point at which improvements slow dramatically and then stop. Your parent has made all the gains their brain and body can make. This plateau point varies wildly. Someone might plateau after two weeks or six weeks or six months. When they plateau, it doesn't mean recovery failed. It means recovery reached its natural endpoint. But it does mean that continuing your parent at a rehab facility stops making sense. They need to move to a different kind of place, or go home if home is possible, or transition to long-term care if that's where they're headed.

This transition is often when families experience the most confusion and pain. You've been focused on recovery. You've been telling yourself, "Once she regains more function, once he can walk further, once she can manage medications, then things will be better." And then rehab staff say, "He's plateaued. We think discharge is appropriate." And suddenly you're facing the reality that this is as good as it gets. Managing that reality is something you should start preparing for now, on the tour, when you ask about the discharge process.

Your Parent's Motivation and Your Role

Watch your parent during the tour. Are they engaged? Anxious? Withdrawn? Are they asking questions about what recovery looks like? Are they expressing fear or determination or resignation? Their mindset going into rehab shapes how the next weeks unfold. A parent who is scared but determined usually does better than one who is depressed or angry or in denial about what happened. Neither is "wrong," but both affect progress.

Your role is to support effort without making it your life. This is a delicate balance that nobody explains to you. On one hand, your presence matters. Visiting regularly, encouraging your parent, asking questions about therapy progress, making sure your parent isn't giving up. On the other hand, you have a life. You need to sleep. You need to work. You need to be functional. Some families spend every waking hour at the facility. Some visit once a week. What matters is consistency and engagement, not hours logged.

When you do visit, ask about the specific therapy sessions. Which ones went well? What was your parent working on? What did they struggle with? Ask your parent what they want to accomplish in rehab. Sometimes their goals and the staff's goals are misaligned. Your parent wants to return home. Staff think a group home is more realistic. The conversation gets awkward. But having that conversation in week one is better than having it in week six when everyone is emotionally exhausted.

Also, understand that encouraging your parent sometimes means accepting their choices, even if you think their choices are counterproductive. Your parent refuses to do the afternoon therapy session because they're tired and want to rest. You can encourage them to go, but ultimately, you can't force them. This is their body. Their recovery. Their effort. As hard as it is to watch someone undermine their own progress, you have to accept that they're an adult making choices, even choices you'd make differently.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different; what works for one may not work for another.