How To Select A Nursing Home

What is a nursing home?

A nursing home is a place where you or your loved one may need to stay when you cannot care for yourself. You or your loved one may need help with daily routines such as bathing, dressing, or grooming. You may also need more specialized (SPESH-al-eye-zd) care such as physical therapy (FIZ-I-kal) (THER-ah-pee) (special exercises). It may be safer for a person to be in a nursing home, than in their own home. A nursing home can also be called a long-term care facility, or rest home.

Why do I need to stay in a nursing home?

You or your loved one may need to stay in the nursing home for a short time to get strong after surgery. Sometimes a nursing home may become a long-term home because you are no longer able to care for yourself. This may happen because of a long-term illness or other reasons. Your caregivers will tell you if a nursing home is needed.

Are all nursing homes the same?

Nursing homes offer different levels of care. A nursing home may offer basic care such as a room, meals, and help with activities of daily living. There may also be activity programs to do with others. Nursing homes may also offer skilled nursing care such as bandage changes, regular treatments, and help with your medicines. They may also have physical therapy and other types of therapy. Your caregivers will help you choose the type of nursing home that is best for you.

How do I gather information about nursing homes?

  • Make a list of licensed nursing homes in the area where you may want to live, or where you may want your loved one to live. Being close to family and friends may make it easier for them to visit more often.

  • There are several sources of nursing home information.

    • Friends, family or clergy.

    • Office on aging in your area.

    • Hospital discharge planners, social workers, or caregivers who work with the elderly.

    • Local AARP (American Association of Retired Persons) chapter.

  • Get information about the quality of the nursing homes you are interested in. There are many things to think about before choosing a nursing home. To help you choose, the following are places that you may want to contact:

    • The local state health department. They may be able to give you information about the nursing home from the nursing home inspection (in-SPEK-shun) report.

    • The local office of consumer affairs for your state.

    • The Ombudsman (OM-budz-muhn) program in your state. Ombudsmen provide information about how to find a nursing home and how to get good care.

    • The Centers for Medicare and Medicaid Services (CMS). CMS also has information about nursing homes and their inspection reports. You can also get this information on their website.
  • Centers for Medicare and Medicaid Services
    7500 Security Boulevard
    Baltimore , MD 21244-1850
    Phone: 1- 800 - MEDICARE
    Web Address:
  • Cost may be important in choosing a nursing home. Find out if the home is licensed to take Medicaid or Medicare. Ask about the monthly base rate and extra charges. Many services such as laundry, catheter (KATH-e-ter) care, and special skin care programs have charges over the base rate. These extra charges can be costly.

  • Make sure that the nursing home is a skilled nursing home if you or your loved one needs special care. Make sure the nursing home has a bed available.

How do I choose a good nursing home?

Visit the nursing homes you are interested in. Visiting nursing homes gives you a chance to see what it is like in person. Take a list of questions you would like to ask while visiting. Talk to some of the residents (people who live there) if you can. Some of the things you should look for are:

  • Residents and resident rooms:

    • Residents are clean and well groomed. They seem alert and peaceful.

    • Resident rooms are clean and have personal storage space.

    • Resident rooms have windows.

    • Residents beds are low enough to prevent falls.

  • Living space:

    • All rooms are clean, and free of strong smells.

    • The temperature is comfortable.

    • The nursing home has good lighting. The nursing home has windows that let natural light in and allow residents to look outside.

    • The noise level is comfortable.

    • There are separate, quiet areas where residents can visit with friends and family.

  • Hallways, stairs and bathrooms:

    • All common areas, rooms, and doorways are made for people who use wheelchairs.

    • Hallways and stairs have handrails. Bathrooms have grab bars.

  • Menus and Food:

    • A dietitian (deye-e-TISH-an) is available to review the menus.

    • Dining room is clean and pleasant.

    • Residents have a choice of food items at each meal. The menus should also change regularly to offer a variety of foods to residents. Ask to see a menu.

    • There are workers (staff) available to help residents eat and drink, if help is needed.

  • Activities:

    • Residents can take part in a variety of activities such as watching movies, taking classes or going on outings.

    • There are outdoor areas for residents to enjoy.

    • There is an active volunteer (vol-un-TEER) program. Visitors, volunteers and clergy are welcome to visit with residents.
  • Staff:

    • Staff and residents seems to be friendly, respectful and cheerful toward each other.

    • Staff members are clean, well groomed and wear nametags.

    • Staff members knock on the door before entering resident rooms. Staff members know and use residents' names.

    • All nursing home staff has had a background check. This check may include a person's past work history, criminal record, and other personal information.

    • There is a full-time Registered Nurse (RN) in the nursing home at all times.

    • Residents are assigned to the same caregivers most days of the week.

    • The nursing home has a licensed doctor on staff who visits regularly, and who can be reached at all times.

  • Safety and Care:

    • Exits are clearly marked. There are smoke alarms, sprinkling systems and fire extinguishers (eks-TING-wi-shers). There should also be an emergency plan in case everyone needs to leave suddenly.

    • Residents are able to see their own doctor. The nursing home arranges for medical care when needed.

    • There is a preventive (pree-VEN-tiv) care program to help keep residents healthy. The preventive program provides services such as immunizations (i-mun-EYE-zay-shuns) for the flu or pneumonia (noo-MOH-nyah).

    • Care plan meetings should be held regularly. These meeting are for residents and family members to attend and give input into your loved one's, or your care.

What should I do after visiting nursing homes?

  • Visit the nursing home you are interested in a second time. Visit the nursing home during a different day, and time of day. Most nursing homes have fewer staff on weekends and evenings. Visiting a second time may give you more information to think about when making your decision.

  • Choose the nursing home that best meets your needs. Talk to your family, friends, caregivers, or a social worker. They may be able to help you select the right nursing home for you.

  • If you are choosing a nursing home for your loved one or a friend, involve him if possible. Keep his values, likes and dislikes in mind if he is not able to help you choose the nursing home.

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about the different types of nursing homes and their quality. You always have the right to refuse treatment.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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