Choosing a nursing home

Choosing a quality nursing home is one of the most important decisions you may have to make. To help you choose a good nursing home for yourself or a loved one, you should consider the following :

Nursing Home Certification

  • Is the nursing home’s state operating license current ?
  • Does the nursing home administrator have a current state license ?
  • If you or your loved one participate in Medicare or Medicaid, is the facility Medicare or Medicaid certified ?

General Nursing Home Operations

How long has the nursing home been in business?
Who owns the nursing home?
Who runs the nursing home; the owner or a manager?
How long has that person run the nursing home?
How can you contact that person?
Can you receive a financial report for the nursing home?
Can you receive a copy of recent inspection reports?
How many residents live in the nursing home?
How many care staff are on duty for all shifts?
What qualifications do the care staff have and what training do they receive?
Is all of the night staff on site, or are some on call?
Does the nursing home have a written policy regarding prevention of abuse and neglect? If so, what is the policy? If not, why?
Is the nursing home a restraint -free facility? If so, what is the restraint policy? If not, is a restraint policy in place?


What is contained in the agreement?
What services are paid by insurance, Medicare, or Medicaid?
What services must the resident pay for? Get a copy of the fee schedule so you can compare it with the fee schedules of other homes.
When must payment be made?
What happens if the resident runs out of money?
Will a bed be available if the resident switches from private insurance to Medicaid?
Is a trial period permitted? If so, how long is the trial period?
What notice must be given if the resident wants to leave the nursing home?
Under what conditions can the nursing home ask the resident to leave?


Does the location suit the resident? Is it close to places and events that the resident wants to attend, like shopping, the hairdresser, or a place of worship?
Are transportation services available so the resident can go where he or she wants and needs to go?
Is the location convenient so that friends and relatives can regularly visit?

The Building Facility

Is there sufficient room in all areas for a person in a wheelchair or one needing a walker to get around?
Are wheelchair ramps provided for easy access into and out of the nursing home?
Are there features in the facility to prevent falls, such as handrails in the hallways and grab bars in the bathrooms?
Is the facility on one floor or more than one floor? If there are multiple floors, are elevators large enough, easily accessible, and easy to use?
In the case of an emergency, are call bells in bathrooms, bedrooms, and communal areas?
Is the entire facility, including rooms, hallways, elevators, stairs, and communal areas, suitably lit?
Are exits clearly marked and are paths to the exits free of clutter and obstructions?
Are there smoke detectors and fire extinguishers? Is the nursing home in compliance with fire codes?
In the case of an emergency, is there an evacuation plan? Are regular evacuation drills conducted?
Is there a safe and easily accessible outdoor area where residents can enjoy the outdoors?
What are the security arrangements?
Are telephones readily available, easily accessible, and private? Do the telephones meet the special requirements of the hearing impaired?

General Appearance of the Nursing Home

Does the nursing home look comfortable, clean, safe, and friendly?
Does the nursing home smell good?
Is the nursing home noisy? Are televisions blasting and call bells ringing?
Is the inside temperature comfortable for the residents?
Do the residents seem happy? Do they smile and laugh?
Is there clutter in the hallway?
Are dishes visible long after mealtimes?
Are the care staff members friendly, caring, and attentive?
Do the staff members seem happy? Do they smile and laugh?
Do the staff members treat the residents with respect?
Does there appear to be enough staff members to meet the needs of each resident?
How long have staff members, such as nursing assistants and nurses, worked at the nursing facility?
Are the nursing stations organized?

Resident Accommodations

Can the resident have a private room?
If the resident has to share a room, can he or she meet the other person before they become roommates? If the two don’t hit it off, can other arrangements be made?
If rooms are shared, are screens or other separators provided for each resident’s privacy needs?
Does each bedroom have its own bathroom? If not, is a bathroom easily accessible?
Are toilets, baths, and showers easy to use while still maintaining privacy?
Can the resident bring some of his or her own furniture or other personal belongings?
Is there a place where the resident can lock up personal and/or valuable items?
Can the resident have a TV and/or private telephone in the room? If private telephones are not permitted, is a telephone readily available, easily accessible, and private? Does it meet the needs of the hearing impaired?
Is the room air conditioned? If so, can the resident control heating and cooling? If not can the resident install an air conditioning unit?
Do the bedrooms open into a corridor and have windows?
Is the room cleaned at least once a week?
Is the resident’s bed made by a staff member on a daily basis?
If married, can spouses share a room?

Communal Rooms and Activities

How many communal rooms are available?
Can the resident choose which communal rooms to visit?
Are the communal rooms easily accessible?
Are toilets within easy access of all communal rooms?
Is the furniture comfortable and clean?
What entertainment is provided? For example, is there a television, radio, piano, and/or board games?
Is there a quiet communal room where a resident can read or make crafts? Are books, magazines, newspapers, or crafts made available?
Are activities planned for communal rooms, such as movies, theme parties, crafts, or low-impact aerobics? If activities are planned, is a schedule posted or is a schedule delivered to the resident’s room?
How frequently are social events and/or outings organized?
Are you or your loved one interested in the planned activities?

Dining Halls and Meals

How many dining halls are available?
Are dining halls easily accessible?
Are toilets easily accessible from all dining halls?
Is the furniture comfortable?
Are the tables compatible for people in wheelchairs?
Is the dining hall and kitchen clean?
Is the kitchen separate from the dining hall?
How many residents sit at a table?
Can the resident choose where to sit and with whom?
When are meals served? Is there an early and late seating for each meal? Can the resident choose the preferred seating time?
Can the resident have input into menus?
Is the food attractive, at the proper temperature and palatable?
Can family members or friends sample the food?
Does the food taste good?
Do the menus include food that the resident likes?
Are there several choices on the menu?
Are the menu selections well balanced and nutritious?
Can menus be altered to accommodate special diets?
Can the resident eat meals other than at set times?
Are snacks and drinks made available at all times?
Can meals be eaten in the resident’s room?

Personal Care

Does the resident have a say in the manner he or she is cared for or helped?
Is a qualified person of the same gender readily available if the resident needs help with bathing, dressing, or toileting?
Can relatives or friends help the resident with bathing, dressing, or toileting?
Does a barber or hairdresser visit the nursing home? If not, how are hair dressing needs met?
Does the facility launder the resident’s clothes, pajamas, and underclothes? How often? Is the service available on demand?
Who provides nail care and how often?

Health Care

Will all health care needs be met, including needs associated with special medical conditions like dementia, End-Stage Renal Disease, or Alzheimer’s Disease?
Can the resident keep his or her current physician?
Is a physician on call 24 hours per day, 7 days per week?
How often does a physician visit the nursing home?
Do other health care professionals, such as dentists and physical therapists, regularly visit the nursing home? If so, how often?
If the resident’s current health care needs change, can he or she continue to live in the nursing home?

Day-to-Day Living

Can the resident get up and go to sleep when desired?
Is there a place to buy small items, like postage stamps and stationery?
Are newspapers and mail delivered daily?
Is there an independent residents’ and relatives’ group?
Is there a safe place for valuables?
Who takes responsibility for insuring possessions?
Can the resident freely practice his or her religion?
Does a practitioner of the resident’s religion visit regularly?
Have the staff members been cross-culturally trained?
Do an adequate number of staff members speak the same language as the resident?


Can family and friends visit without restriction?
Are there places where the resident can privately meet with guests?
Can visitors dine with the resident?
Can visitors stay overnight?
Can the resident offer guests snacks or beverages?

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