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Twenty Tips For Choosing a Nursing Home or Assisted Living Facility

Some helpful tips that Medicare and others recommend when deciding on a long-term care facility include:

  1. Make a list of what you are looking for as far as location, special services, atmosphere, etc. Ask your doctor, friends, family, neighbors, clergy and others for recommendations. Check ratings and read the inspection reports online. Compare the quality. Click here for further information.
  2. Call during business hours to speak to someone who can answer your questions. This may include the administrator, admissions coordinator or social service director. Pay attention to how you are treated on the phone. Does this sound like a place where you would like to live?
  3. Find out about costs and whether there is a bed available. How will you pay for the facility? What forms of payment do they accept?
  4. Schedule an appointment with the admissions director for the first visit. Ask to meet such key staff as the administrator, the director of nursing, the dietitian, activity director and any specialists. Then go back at a different time of the day for unscheduled visits to get a truer, more informal sense of the place.
  5. Make a list of your questions. During your visits, be observant and use your sight, hearing and smell. Take notes.
  6. Ask for the home’s brochure, admission policies and residents’ “Bill of Rights.”
  7. Visit during a meal, on evenings or during weekends, to see how staffing levels vary and meals are handled. Check out the food and ask to see the kitchen. Have a meal.
  8. Ask to see several floors of the home, the activity rooms, the dining area and other gathering areas – preferably when people are using them. Beware of the “chandelier syndrome,” in which a home has a fancy, glossy lobby but poorly maintained resident areas.
  9. Observe how the staff and residents interact. Are the residents spoken to with respect as adults, not as children? Is the staff friendly and accommodating? When talking with staff members, ask yourself: Do they seem sincere?
  10. Stop and talk with residents and family members about their experiences. Ask to talk to the head of the resident’s council or the family council.
  11. See if residents are dressed appropriately for the time of day, well-groomed, alert and involved with others. Do the residents appear happy, comfortable and at home?
  12. Check out the weekly activities calendar and how lively the home is. Are all the residents sitting in their rooms alone, or are they lined up and sleeping by the nursing station?
  13. Is it very noisy or too quiet because there is no activity?
  14. Specifically, check to see if residents with Alzheimer’s get special care and what activities, if any, they’re involved in.
  15. Are residents being taken care of in a timely manner? Are call bells unanswered?
  16. Is staffing adequate, and does the staff seem to care about the needs of the residents?
  17. If the building is older, remember that doesn’t reflect the quality of care. What’s more important, besides it being a nurturing environment, is that it’s clean and safe.
  18. Is there hot water in the bathrooms? Is the temperature in the facility comfortable, or is it too hot or too cold?
  19. Is the facility clean, tidy, and odor-free?
  20. Are the rooms decorated with personal furnishings and belongings? Do the residents have adequate privacy?

While not intended to be a complete list, these types of questions are based on common experiences and are grounded in the fundamental philosophy that our loved ones should get the care for which they are paying. Our elders do not “sign away” their rights to dignity and comfort when entering a long-term care facility. Be vigilant and proactive.

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