Choosing a Nursing Home and What to Check on a Visit¶
A family member may need a nursing home for different reasons: recovering from surgery or an illness, or needing ongoing help with daily activities like bathing, dressing, or eating.1 This page covers the first decision point — picking a nursing home and knowing what to look for on a visit.
What this page does not cover yet
This page is scoped to choosing a facility and visiting it before or after a move. It does not yet cover assisted living specifically, how to prepare for moving day itself, staying involved as a caregiver once someone has moved in, or how to work with a facility social worker. Those are separate, not-yet-written parts of this guide.
Know what kind of care you're choosing¶
Nursing homes can provide two different things, and it matters which one you need:
- Short-term care — rehabilitation after surgery (for example, physical therapy after a hip or knee replacement) or skilled nursing to recover from an illness like pneumonia.
- Long-term care — ongoing help with daily activities, and, at some facilities, specialized care for Alzheimer's disease or other dementias.1
Coverage differs sharply between the two. Medicare Part A covers up to 100 days of short-term nursing or rehab care in a Medicare-certified nursing home after a hospital stay, and Part B and Part D cover related doctor visits, therapy, and prescription drugs. Medicare generally does not cover long-term nursing home stays.1
If long-term care is needed, your state's Medicaid program may cover it if the person qualifies, and Medicaid may also cover home-and-community-based services or assisted living, depending on the state.1
Before deciding anything, talk to someone you trust — a family member, the person's health care provider, or a social worker.1
Find and compare facilities¶
Medicare.gov/care-compare lists nursing homes and rates each one 1 to 5 stars, based on combined health-inspection, staffing, and quality-measure ratings. All facilities listed there are Medicare-certified, meaning they've met a Medicare-approved level of quality and passed required inspections.1
What the ratings can tell you:
- Health inspections — three years of comprehensive, infection-control, and complaint-based inspection results, including any citations for failing federal standards.
- Staffing — nursing-staff hours per resident per day (higher is generally better for comparison) and staff turnover (lower is generally better).
- Quality measures — facility-level performance on things like flu-shot rates, falls, hospitalizations, and antipsychotic-medication use.
- Special-focus and abuse alerts — a facility without a star rating and marked instead with a special-focus symbol has a documented history of serious quality issues and faces more frequent inspections; a separate symbol flags facilities cited for abuse.1
Star ratings are a screening tool, not a substitute for visiting.1
What to check and ask on a visit¶
Schedule a visit before choosing, and talk to current residents and their families if you can. During the tour, watch for slow staff response, strong odors, residents calling out, or unsupervised safety risks.1
Questions worth bringing, organized by what they cover:
- Care planning — How will I (or my family member) be involved in the care plan? How does the facility handle medical emergencies? How do you report and get updates on a concern?
- Dementia care (if relevant) — Is there a designated dementia care unit? How are staff trained for dementia care? Is the unit locked with safe outdoor access? How does the facility avoid antipsychotic medication where possible, and how does it prevent unsafe wandering?
- Staffing and fees — How many staff are assigned per resident, by shift? Does the facility accept Medicare and/or Medicaid? Can you get an itemized list of what's included in the base rate versus billed separately?
- Daily life and preferences — What activities are offered, and can residents help choose them? Can the resident bring their own furniture, choose roommates, and set their own routine for meals, waking, and sleeping? Is there private space for visitors?1
Note: nursing homes that accept Medicare or Medicaid payments must comply with federal requirements, and Medicare separately publishes "Your Guide to Living in a Nursing Home" for residents' rights once someone has moved in.1
Get free, personalized help¶
You don't have to do this alone. The Administration for Community Living's Eldercare Locator (1-800-677-1116, eldercare.acl.gov) can connect you to local long-term-care resources, and every state has an Office of the Long-Term Care Ombudsman that offers free, personalized help choosing or evaluating a nursing home, reachable through theconsumervoice.org/get-help.1