One of the key times to visit a facility to assess the quality of care is at meal time. Give the facility the benefit of the doubt and make your first visit a scheduled visiit. However, make more than one visit and make one of the visits a meal time visit. At a recent assisted living assessment of my one my patients, it was meal time. There were a number of residents sitting at their places and not eating. One man had fallen asleep at his meal and his head was lying on the table. The food was uneaten on all of the resident's plates. When meal time was over the dining room was cleared for the second seating of residents. These first seatiang residents were moved from the dining room without having eaten any food. No one cued them to eat. No helped to feed them. They left the dining room without having eaten anything at the noon meal. The only staff in the dining room were wait staff. They were not concerned about intake. There were no nursing staff in the dining room to assist those residents with needs. When you see this once, a second visit should be done. The first occurrence may have been a unique episode, but if it occurs the second time the facilit should not be considered as a place of resdience. If a loved one is already at the faciity, a care planning meeting or a meeting with the nurse manager of the unit is in order.