How to Choose a Nursing Home

A comprehensive, step-by-step guide to evaluating nursing homes and making the best decision for your loved one's care and well-being.

Choosing a nursing home is one of the most important decisions you'll make for your loved one. Take your time, do thorough research, and don't hesitate to ask difficult questions. Quality facilities will welcome your scrutiny and be transparent about their operations.

Examine government inspection reports, star ratings, and any citations or complaints filed against the facility.

• ✓Look at the overall 5-star rating and individual health, staffing, and quality ratings

• ✓Read recent inspection reports for patterns of issues

• ✓Check for serious violations or repeated problems

• ✓Review how quickly facilities corrected any deficiencies

Start by identifying facilities in your area and gathering basic information about their services, specialties, and availability.

• ✓Use Medicare's Nursing Home Compare tool for initial research

• ✓Consider location relative to family members who will visit

• ✓Verify the facility accepts your insurance or payment method

• ✓Check if they have availability in the care level needed

2.Review Ratings and Inspection Reports

1.Research and Initial Assessment

Visit facilities at different times of day to observe daily routines and care quality firsthand.

• ✓Tour during meal times to observe dining and nutrition

• ✓Visit unannounced if possible to see typical operations

• ✓Observe cleanliness, odors, and overall maintenance

• ✓Note resident appearance, engagement, and demeanor

Adequate, well-trained staff is the single most important factor in quality care.

• ✓Ask about registered nurse to resident ratios during all shifts

• ✓Inquire about staff turnover rates and tenure of key personnel

• ✓Observe staff interactions with residents during your visit

• ✓Verify staff credentials and ongoing training programs

4.Schedule In-Person Visits

3.Evaluate Staffing Quality

Visit facilities at different times of day to observe daily routines and care quality firsthand.

• ✓Tour during meal times to observe dining and nutrition

• ✓Visit unannounced if possible to see typical operations

• ✓Observe cleanliness, odors, and overall maintenance

• ✓Note resident appearance, engagement, and demeanor

Adequate, well-trained staff is the single most important factor in quality care.

• ✓Ask about registered nurse to resident ratios during all shifts

• ✓Inquire about staff turnover rates and tenure of key personnel

• ✓Observe staff interactions with residents during your visit

• ✓Verify staff credentials and ongoing training programs

4.Schedule In-Person Visits

3.Evaluate Staffing Quality

Beyond medical care, residents need social engagement, activities, and dignity.

• ✓Review activity calendars and observe participation rates

• ✓Ask about accommodations for cultural, religious, or dietary preferences

• ✓Observe resident dignity in care delivery (privacy, respect)

• ✓Inquire about family involvement opportunities and visiting policies

Ensure the facility can meet your loved one's specific medical and personal care needs.

• ✓Verify availability of specialized services (physical therapy, speech therapy, etc.)

• ✓Ask about physician availability and how medical emergencies are handled

• ✓Inquire about medication management and pharmacy services

• ✓Understand their approach to pain management and end-of-life care

6.Evaluate Quality of Life

5.Assess Medical and Care Services

Compare your top choices and make an informed decision based on all factors.

• ✓Create a comparison chart with your priority factors

• ✓Trust your instincts about how the facility feels

• ✓Involve your loved one in the decision when possible

• ✓Have a backup option in case your first choice has no availability

Get clear information about all costs, billing practices, and contract terms before admission.

• ✓Request itemized pricing for all services and potential add-ons

• ✓Understand what Medicare/Medicaid covers versus out-of-pocket costs

• ✓Review contract terms for discharge policies and rate increases

• ✓Ask about financial assistance programs or payment plans

8.Make Your Decision

7.Understand Costs and Contracts

The best nursing home for your loved one is one that provides safe, dignified, person-centered care with adequate staffing, transparent operations, and a track record of quality. Don't rush the decision—visit multiple facilities, ask tough questions, and trust your observations.

Remember: You are your loved one's advocate. If something doesn't feel right during your research or visits, investigate further or consider other options.

- Key Takeaway