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

• Does the nursing home have a current state operating license?
• Does the nursing home administrator have a current state license?
• If you or your loved one receive 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 members are on duty for all shifts?
• What qualifications do the care staff members 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?
• How does the nursing home address complaints and questions about the treatment of its residents?
• How often does upper management conduct inspections to make sure all staff are providing proper treatment to the nursing home's residents?

Nursing Home Resident Agreement

• 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 does the nursing home require if a resident wants to leave?
• Under what conditions can the nursing home ask the resident to leave?

Nursing Home Location

• 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 visit regularly?

The Nursing Home Building Facility

• Is there sufficient room in all areas for a person in a wheelchair or using 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 a staff member always available to help a resident go to the bathroom or move around if he or she needs assistance?
• 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 being outside?
• What are the security arrangements?
• Are telephones readily available, easily accessible, and private? Do the telephones meet the special requirements of those who are 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 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 in Nursing Homes

• 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? Who has access to the items besides the resident?
• 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 those who are 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?

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?
• Can family members or visitors bring a resident food?

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 clean the resident's clothes, pajamas, and underclothes? How often? Is the service available on demand?
• Who provides nail care and how often?

Health Care in Nursing Homes

• 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? If not, and a resident has a medical need, how is that addressed?
• 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?
• 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?

Visitors

• 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?