How to Choose a Good Nursing Home


The first step in choosing a good nursing home is to decide on location.

For example, if you live in another state would it be better to move your loved one to a facility near you, or would remaining in their current community be more beneficial? If your family member is more socially active, removing them from their primary support network could be detrimental. However, being closer to where you live allows you to be more involved in and to better monitor their care.


Now that you've chosen a location, the next step is to find out what nursing facilities are available in that area - and which ones are worth checking out.

Nursing homes are highly regulated, and must meet certain standards in order to participate in Medicare/Medicaid and to maintain licensure. A directory of nursing homes and the results of their government surveys can be found at - - and are searchable according to area or name. This site also provides a guide for how to evaluate the survey information presented so you aren't left guessing whether the review means the nursing home was good or bad!


Based on the information you gathered in Step 2, choose at least two of the nursing homes you found and call them.


Talk to the administrator, talk to social services, talk to admissions, talk to everybody! Some questions you may want to ask include:

What are the types of care you provide?
What kind of rooms do you have available?
What is the staff-patient ratio, or how many staff members will be assigned to care for my family member?
What kind of staff do you hire - nurse's aides, nurses? Are they licensed?
What other resources does your facility offer? Do you have daily activities? Do you have social services support staff? Do you have physical therapy, if needed?
What safety measures do you have in place - for emergencies, falls, etc.? What would you do if my loved one suddenly became seriously ill or needed to go to the hospital?
Are there restrictions on when I can visit or when I can take my loved one outside the facility?
What sort of access to the telephone will my family member have? How do you handle patient requests for things they want or need?

These are all just to get you started, of course you may have more questions or other special requirements. Let the facility staff know what you need and what you are looking for, and make sure you get all your questions answered.


The final step in choosing a good nursing home is to visit the facility and evaluate it yourself.

This can be difficult if you live in another state, and if you can't go yourself try to send a friend or family member whose judgment you can trust instead. Sometimes the facility prefers to set up a tour with you ahead of time so that they can ensure someone will be available to show you around and answer your questions, so it's usually best to call before you go.

There are several key things you should look for when evaluating the facility. It may sound silly, but the first thing you should note is how the place smells. Does it smell clean? If you walk in and it smells strongly of urine, feces, or other unpleasant odors, chances are the residents are not being cared for properly or the housekeeping staff is being negligent. See how the residents look. Are they clean, and do they look comfortable in their wheelchairs? If they are not in a wheelchair, do they have the appropriate assistance when walking? Ask to look in a few of the rooms to see how well things are maintained. Talk to some of the nurses. Observe their interactions with the residents. Are they polite and friendly? Do they smile? Also, talk to some of the residents, get their views. You can be sure they'll tell you if things are good or bad!

Finally, go with your feelings and impressions. You've already ensured in Steps 2 & 3 that this facility meets government standards and that the care provided is appropriate for your loved one's needs. At this point, it simply becomes a matter of taste and comfort.

Tips and Warnings

  • Don't forget to include your family member in the decision-making process, if they are capable, or at least get their input if they are impaired. After all, they're the one who has to live there!
  • If you've received a referral to a facility, call them first! People are not going to recommend a lousy nursing home. If your physician is the one you received the referral from chances are they have other patients at that facility, which may mean you don't have to switch doctors in order to be covered under Medicare/Medicaid or your insurance.
  • There are programs that will help provide clothing, eyeglasses, and other personal items if you or your loved one cannot afford these expenses. Check with the social services staff.
  • Medicare and Medicaid may not pay for all of the costs associated with your loved one's care! Certain procedures, medications, and other expenses may not be covered, so check with your doctor or the facility's medical billing staff regarding what is and isn't paid for. Usually, if something is really necessary, alternatives can be found.
  • Often when a family member becomes ill or unable to care for themselves, a single person is left with the responsibility of making the final decision regarding finding an appropriate care facility. Even if you are not doing this by yourself, it can be a daunting task, but here is a fairly easy and efficient step-by-step method for gathering and sifting through the information you need to make a sound decision.