Choosing a Nursing Home: Criteria, Comparisons & Questions to Ask
A nursing home is a residential care facility that provides a range of medical and personal services for patients or older adults who can no longer be cared for at home. Families often begin searching for a nursing home when a loved one is unable to manage activities of daily living or when they frequently wander, sleep poorly, or show signs of agitation. Finding the right nursing home is a challenging and complex task, made more difficult by the varying levels of care and quality across different facilities. Therefore, it’s crucial to approach this decision with thorough planning and consideration.
Experts emphasize the importance of diligent research, including examining federal government records and personally inspecting facilities. With over 15,000 nursing homes in the nation, many families find themselves pressured into quick decisions, often due to sudden hospital discharges. This guide aims to help you find and compare facilities, ask essential questions, and make the best choice for your loved one, prioritizing their safety, comfort, and well-being.1,2
Finding & Comparing Nursing Homes
When researching and evaluating nursing homes, consider various important factors to ensure the best possible care for your loved one:
Facility Location
It’s best to focus on reputable facilities close to relatives and friends, as this ensures frequent visits and better oversight of care. However, due to workforce shortages and limited resident capacities, families should also be prepared to expand their search if necessary to find a suitable facility. 2
Accessibility & Transport
Accessibility is a critical factor to consider, especially for residents with disabilities. Ensure the facility has features like ramps, wide doorways, and accessible bathrooms to aid in mobility. Additionally, check if the nursing home provides transportation services for medical appointments and outings to nearby spots. 4
Services & Amenities
Consider the available services and amenities such as the shared spaces, outdoor areas, dining areas, beauty salons, group outings and social activities. While these amenities can enhance the resident’s experience, they may come at an additional cost. Also be aware of the ‘chandelier effect,’ where the allure of fancy décor or higher prices may not guarantee better care.2,3
Level of Care
It’s essential to consider the current and future needs of the individual. This may include assistance with daily activities, physical therapy, skilled nursing care, medication, or specialized Alzheimer’s care. If you’re unsure which kind of care services are needed, consult a health care provider for care plan guidance. 4
Cost & Payment Options
Paying for nursing home care is a major concern for most families. Medicare may cover short-term stays following a hospital discharge, but long-term care is typically paid out of pocket until personal resources are depleted. At that point, many nursing home residents become eligible for Medicaid, which covers most nursing home costs for those with limited income and assets. It’s important to ensure that the nursing home you choose accepts Medicaid if the older person will be relying on it from the beginning. 1
Online Resources & Tools
For those exploring long-term care options, several resources can assist in making informed decisions:
Start by visiting the Eldercare Locator or LongTermCare.gov for information on housing options and local services. Additionally, reach out to your local Area Agency on Aging or state human services department for personalized assistance.
Utilize the Centers for Medicare and Medicaid Services comparison tool to compare nursing homes and healthcare facilities by entering your zip code. This offers a valuable resource for comparing quality ratings, health inspections, and other essential details. Consider reviewing the facility star rating including RN Staffing, Quality Measures rating, and Survey report. Another way to ensure quality is by checking the ratings and inspection details with the Joint Commission’s Quality Check. 3,4
Questions to Ask a Potential Nursing Home
To further narrow your search and ensure you find the right fit, it’s crucial to ask specific questions when evaluating potential nursing homes. Here are some important questions to ask:
- Is the nursing home certified by Medicare or Medicaid? Is it accredited by The Joint Commission?
- Can you provide information on state regulations regarding care provision, especially during public health emergencies like infectious disease outbreaks?
- How many caregivers are assigned per resident during the day and night shifts? What are their qualifications and training?
- What is the turnover rate for key staff members such as heads of nursing, food services, and social services? Do employees get background checks?
- Is there a physician who visits regularly? How often do residents receive medical check-ups, especially during evenings and weekends?
- How do nursing home residents typically get to medical appointments?
- Does the facility have a dedicated unit for residents with Alzheimer’s or dementia? What specialized services are provided?
- How is pricing structured? What services are included in the monthly cost, and what services cost extra? Does the pricing change annually?
- What recreational activities are offered during the week and weekends? Can families attend these activities?
- Is there a secure outdoor area for residents to use?
These questions can help you gather essential information to make an informed decision.
Choosing the Nursing Home
Now that you have your list of facilities and essential questions, you are ready to start touring the top communities to make your final decision.
Schedule Tours & Observe
Schedule multiple tours and inquire about each community’s services, costs, and availability, ensuring to mention any specific needs or preferences. During visits, observe the interactions between residents and staff closely—look for warmth, respect, and attentive care. Pay attention to residents’ grooming and the cleanliness of the facility and take note of response times to call lights and medication needs. These observations provide invaluable insights into the quality of care and environment each facility offers, guiding you in making a well-informed decision. 2,4
List Priorities & Preferences
Prioritizing and considering your loved one’s needs and preferences is important in making the right nursing home decision. Begin by making a list of priorities, such as the level of care required, cost considerations, and desired amenities. Involve your loved one in this process to understand their preferences—whether it’s the location, specific activities, or cultural and social connections they value.
Take time to discuss and evaluate what aspects of daily life are most important to them and address any concerns they may have about moving. By aligning these priorities with your search criteria, you can ensure you find a nursing home that meets both practical needs and personal preferences, providing a comfortable and supportive environment for your loved one. 3,4
Trust Your Research & Instincts
When making the final decision, trust your instincts and choose the nursing home that feels most comfortable and welcoming to both you and your loved one. While no place is perfect, prioritize finding one that best meets their specific needs and preferences, seeking support from healthcare providers, family members, and friends along the way. Remember, this decision can be emotionally challenging, but with thoughtful consideration and proactive planning, you’re ensuring the best possible care and quality of life for your loved one. 1
References
[1] “Caregiver Guide: Choosing a Nursing Home.” Caregiver Guide: Choosing a Nursing Home | HealthInAging.Org, www.healthinaging.org/tools-and-tips/caregiver-guide-choosing-nursing-home. Accessed 26 June 2024.
[2] Schoch, Deborah. “Tips to Find a Quality Nursing Home for Your Loved One.” AARP, www.aarp.org/caregiving/basics/info-2019/finding-a-nursing-home.html. Accessed 26 June 2024.
[3] Whitley, Merritt. “A Guide to Choosing a Nursing Home.” A Place for Mom, www.aplaceformom.com/caregiver-resources/articles/choosing-a-nursing-home. Accessed 26 June 2024.
[4] How to Choose a Nursing Home or Other Long-Term Care Facility | National Institute on Aging, www.nia.nih.gov/health/assisted-living-and-nursing-homes/how-choose-nursing-home-or-other-long-term-care-facility. Accessed 26 June 2024.
[5] “Find Healthcare Providers: Compare Care near You.” Medicare, www.medicare.gov/care-compare/. Accessed 22 July 2024.
The information provided in the article is for general informational purposes only. This information is not a substitute for medical advice. Accordingly, before taking any actions based upon such information, you are encouraged to consult with the appropriate professionals.
