Guide to Choosing a Nursing Home

We recommend everyone read the official Medicare guide to choosing a nursing home. It can be downloaded directly from Medicare HERE. Below are some highlights with additional commentary by our staff.

Choosing a Nursing Home

Choosing a nursing home is an important decision. There are steps you can take to find the nursing home that is best for you or for a loved one. Planning ahead will help you make a nursing home choice that meets your needs and provides quality care.

  • Ask people you trust, like your doctor, family, friends, neighbors, or clergy if they have had personal experience with nursing homes. They may be able to give you the name of a nursing home where they had a good experience.
  • Call your Area Agency on Aging. Their telephone number should be listed in your local telephone directory. This agency can give you information about the nursing homes in your area. You can get the telephone number of your local Area Agency on Aging by looking at www.aoa.gov on the web. Select “About AoA and the Aging Network.” Then select “Area Agencies on Aging.”
  • Call the Medicare Eldercare Locator at 1-800-677-1116 (weekdays 9:00 a.m. to 8:00 p.m. Eastern time) for information about nursing homes in your area.

Quality care means doing the right thing, at the right time, in the right way for the right person, and having the best possible results. Nursing homes are certified to make sure they meet certain Federal health and safety requirements.

To find out how nursing homes compare in quality in your area, look at www.medicare.gov on the web. Select “Nursing Home Compare.” You can compare the State inspection reports of the nursing homes in your area and look at other information, like resident characteristics and staffing levels.

Starting spring 2002, for each nursing home in the states of Maryland, Ohio, Colorado, Rhode Island, Washington, and Florida, you can see quality information on “Nursing Home Compare,” including:

  • The Percentage of Residents Who Need More Help Doing Daily Activities than when their need for help was last assessed, like;
    1) feeding oneself, 2) moving from one chair to another, 3) changing positions while in bed, and 4) going to the bathroom alone.
  • The Percentage of Residents with Pressure (Bed) Sores. These are usually caused by constant pressure such as lying or sitting in one position for a very long time.
  • The Percentage of Residents Who Lost Too Much Weight, which might be unhealthy.
  • The Percentage of Residents with Pain. This is very bad pain that happens everyday, over the last 7 days, and is very bad or moderate.
  • The Percentage of Residents with Infections. These include pneumonia, wound infections, urinary tract or a bladder infection.
  • The Percentage of Residents in Physical Restraints. Physical restraints are any device that keeps a resident from moving freely, like ankle restraints, special types of vests, or chairs with lap trays.
  • The Percentage of Short-Stay Residents (residents who stay for less than 90 days) Who Improved in Walking. Short-stay residents are in the nursing home less than 90 days. Improvement in walking is an increase in a resident’s ability to walk with little or no help at all.
  • The Percentage of Short-Stay Residents with Pain.
  • The Percentage of Short-Stay Residents with Delirium, which is a mix of short-term problems with focusing or shifting attention, being confused and not being aware of one's surroundings. These symptoms may appear suddenly and can be reversible. (Note that delirium is not “senility,” which is more about learning and memory problems.)

Other ways to find out about nursing home quality:

  • Ask friends and other people you know if they are or were satisfied with the quality of care.
  • Call the local office of consumer affairs for your state. Ask if they have information on the quality of nursing homes (look in the blue pages of your telephone book for their telephone number).
  • Call your State health department. Ask if they have information on the quality of nursing homes (look in the blue pages of your telephone book for their telephone number).
  • Before you make a decision about the nursing home, visit the nursing homes you are interested in. A visit gives you the chance to see the residents, staff, and facility. It also allows you to talk with nursing home staff, with the people who live and get care at the nursing home and their family members. Be sure to call the nursing home office and make an appointment to tour the nursing home before you visit.
  • If you can't visit the nursing home yourself, you may want to get a family member or friend to visit for you. If a family member or friend can't visit for you, you can call for information. However, a visit gives you a better way to see the quality of care and life the residents get.
  • Call About Services:
    • What services does the nursing home provide?
  • Call About Fees:
    • Do they charge a basic fee for room, meals, and personal care?
    • Do they charge extra for other services or care for special medical needs?
  • See the Inspection Report:
    • Get a copy of the nursing home inspection report from “Nursing Home Compare” at www.medicare.gov on the web (see page 27). The inspection report tells you how well the nursing home meets Federal health and safety requirements.
    • The nursing home must have the results of the most recent survey of the facility done by Federal or State surveyors available for you to look at.
  • Visit the Nursing Home
  • Before your visit, go over any information you have already gathered.
  • Make an appointment with the nursing home before you visit.
  • Take a formal tour with a nursing home staff member.
  • Visit Again:
    • Revisit the nursing home a second time, on a different day and at a different time of the day than when you first visited. Staffing can be different at different times of the day, and on weekends.
    • Try to visit during the late morning or midday. This allows you to see the residents when they are out of bed, eating, and going to activities.
  • Go to Council Meetings:
    • Ask a nursing home staff member if you can get permission from the resident’s or family council’s participants to attend a meeting of the nursing homes’ resident council and/or family council meeting. These councils are usually organized and managed by the resident's families to improve the quality of care and life for the residents and address concerns.
  • Ask Questions
    • Is the nursing home certified by Medicare and Medicaid?
    • Is there a bed available? (Is there a waiting list?)
    • Is the nursing home easy to visit for family and friends?
    • Ask to see a copy of the nursing home's most recent inspection report. If any deficiencies were found, ask if they have been corrected and ask to see the plan correction.
  • Ask about Satisfaction:
    • Talk to staff, residents, and family members if you can. Ask them if they are satisfied with the nursing home and its services.
  • Other Questions:
    • Write down any questions you still have about the nursing home or how the nursing home will meet your needs.
    • Ask the staff about the quality information from “Nursing Home Compare,” at www.medicare.gov on the web. This may help you compare nursing homes.
    • Ask the staff to explain anything you see and hear that you don't understand. For example, a person may be calling out. It may be because they are confused, not because they are being hurt or neglected. Don't be afraid to ask questions.

Don't go into resident rooms or care areas without checking with the resident and nursing home staff first. Residents have a right to privacy.