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?
- 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?
- 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?
- 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?