Topic Overview

When considering moving into a nursing home, also called a resident
care facility, you can take steps to make sure you select the place that best meets
your needs.

  • Visit several nursing homes with your family.
    Most nursing homes have an admissions coordinator who is able to answer your
    questions and show you the facility. Discuss what you like and dislike about
    each facility. It may be helpful to keep written notes about each facility.
    Don’t hesitate to ask for written material from each facility you visit. You
    may want to visit each facility more than once.
  • Is the nursing home
    conveniently located to your family? You may want to choose a nursing home that
    your family members can visit frequently.
  • Note the appearance of
    the nursing home. Is it clean and odor-free? Is the environment safe? The
    nursing home should have smoke detectors and sprinklers. Handrails should be
    present. Exits should be clearly marked and unobstructed. The halls and rooms
    should be clear from obstacles. Floors should be free from spills. The
    temperature in the facility should be comfortable.
  • Your state
    government oversees the licensing of nursing homes. The most recent state
    inspection report should be posted for the public to read. If you do not see it
    posted, do not hesitate to ask to see a copy. The state inspection report will
    alert you to any violations the facility has received and the actions taken to
    correct these violations. In addition to your state’s regulation, the Health
    Care Financing Administration (HCFA) is the branch of the Health and Human
    Services department of the federal government that oversees Medicare and
    Medicaid programs. HCFA provides Medicare and Medicaid reimbursement to nursing
    homes to provide care for the elderly and disabled. HCFA regularly inspects
    nursing homes to ensure that Medicare and Medicaid guidelines are met. Do not
    hesitate to ask the facility about its most recent state and federal
    inspections.
  • Ask about licensure. The nursing home and its
    administrator should be licensed to operate by the state in which you
    live.
  • Talk to the admissions coordinator about the nursing home’s
    hiring practices. Does the nursing home screen potential employees for a
    history of abuse?
  • What is the education level of the staff? Many
    nursing homes are staffed primarily with certified nursing assistants (CNAs),
    who provide the majority of care to residents. Training programs for CNAs vary
    from state to state. Most training programs are several weeks to months in
    length, and provide training to care for elderly, homebound, and ill people. A
    licensed practical nurse (LPN) or registered nurse (RN) should be available at
    all times to oversee the care given by the CNAs. What type of ongoing training
    does the staff receive?
  • Is the nursing home able to retain
    qualified staff members, or is the turnover rate high? Visiting on more than
    one occasion will give you the opportunity to see if the same staff members are
    present consistently.
  • Ask about the medical services at each
    facility. Will your doctor be able to direct your care, or does the nursing
    home have a medical director who will oversee your care? If a medical director
    will manage your care, how often does he or she make visits? Will you be able
    to talk to the medical director if you have questions or concerns? Will the
    medical director meet with you and your family if necessary?
  • Visit
    the dietary department of each facility. Visit at mealtime. Are meals served on
    time? Are meals attractive? What steps will be taken to manage your specific
    dietary needs? If you are unable to feed yourself, staff should be readily
    available to assist you.
  • Check the residents’ rooms. Are individual
    rooms available, or will you share with another resident? Are you able to bring
    in your own furnishings? Space should be ample, and the rooms should be free
    from clutter. Are televisions and telephones available in each room? Ask about
    bathroom facilities. Will you have you own bathroom, or are these
    shared?
  • Is a pleasant area available outside, such as a yard or
    garden area?
  • Is there an area for children to play?
  • Are
    pets and plants allowed?
  • Observe the residents. Do they appear
    clean and comfortable? Is the nursing home staff responsive and friendly?
    Notice how long it takes for call lights to be answered. Do you see staff
    members helping residents change their positions regularly (for example,
    turning in bed, or moving from the bed to a chair)? How does the staff handle
    confused or aggressive residents? What is the nursing home’s policy for
    restraining confused or aggressive residents?
  • Ask about services
    available at the facility. Does the facility have a social director who
    oversees social events for the residents? There should be an assortment of
    activities available that appeal to a wide range of residents. Are religious
    services available? Does the facility offer the services of a hairdresser or
    barber? What laundry services are available? Are hospice or other specialized
    services (such as Alzheimer’s care) offered, and, if available, is there a
    waiting list for these services? Call or visit a local hospice program to ask
    about which nursing homes they most frequently work with.
  • Ask about
    cost and payment options. Nursing home costs can vary greatly, depending on the
    facility and the type of care offered. Monthly costs can range from $2,500 to
    $3,000 or more. Many people pay for nursing home services out of their own
    personal resources. Some people have paid long-term care insurance that helps
    cover some nursing home expenses. Medicaid and Medicare offer limited resources
    for people who qualify. For more information on nursing home services and
    Medicare and Medicaid benefits, you can call toll-free (1-800-633-4227) or
    visit the Medicare Web site (www.cms.gov).

To learn more about how to choose a nursing home, see:

Aging Well: Choosing a Nursing Home

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ByHealthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD – Internal Medicine
Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Shelly R. Garone, MD, FACP – Palliative Medicine

Current as ofOctober 6, 2017