Caring Checklist: Evaluating a Nursing Home

What to ask -- and what to look for
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Be sure to print this out and keep notes at each step; the more detailed responses and observations you record here, the more easily you'll be able to compare your options later.

Initial phone or online research

How much does care and housing cost for someone with my loved one's current needs -- and what does that include?

Is the facility certified to accept Medicare and Medicaid?

Are there currently any openings?

  • If not, what's the expected waiting period?

When can I tour the facility?

Initial visit

Your initial visit will likely include a brief interview with a staff member or marketing person, followed by a guided tour, during which you can record your own observations and request documents to review later.

Is the location convenient for family and friends to visit?

Is the facility pleasant and appealing?

Are there private rooms or spaces for residents and their visitors?

Are residents' rooms pleasant and appealing?

  • Are living spaces personalized with photos, mementos, or other possessions?

  • Is there adequate closet and storage space?

Do staff members seem attentive and caring?

  • Do they interact well with one another?

  • Do they seem to know residents' names?

Do the residents seem reasonably happy and well cared for?

  • Are most of them in their beds or out and about?

  • Do they appear to be at or near my loved one's level of functioning?

Do residents appear to enjoy their food?

Do the residents seem engaged and interested in the activities provided?

Request documents

It's a good idea to get as many of the following documents as possible. They can help you compare the fine details of one nursing home versus another.

  • Sample admission contract

  • Statement of residents' rights and responsibilities

  • Recent list of weekly activities and events

  • Recent weekly menu of meals and snacks

  • Recent report or agenda from a resident or family council meeting

  • Most recent inspection reports by state and federal authorities

  • Records showing the facility's financial stability

Follow-up questions

If your initial visit, impressions, and document review were positive, arrange a second visit or a phone call to get answers to more detailed questions about care and services there.

Does the cost include any special move-in fees or fees for services, such as laundry?

  • Under what circumstances might costs go up?

  • When was the last rate increase?

What special training has staff received?

What's the ratio of staff to residents?

What's the staff turnover rate?

Are background checks performed?

  • If so, when and how?

Is an initial assessment of needs conducted and a written care plan developed?

  • If so, who's involved?

  • How often are needs reassessed?

What specific care is available from doctors, nurses, physical therapists, occupational therapists, and others?

  • Is transportation provided for offsite medical appointments?

  • Is the facility affiliated with a particular clinic, hospice, or hospital if more care is needed?

What procedures are followed in case of a medical emergency?

Barbara Kate Repa

Barbara Kate Repa, a lawyer and journalist, has devoted her career to editing and writing about legal issues for consumers. See full bio

over 1 year, said...

What medical documents are needed to get my loved one into the nursing home? Which doctors signs my mother into the nursing home? Does her primary care physician follow her? Her other specialty physicians? Does she have to have new doctors now? Does she need a PRI? a Screen? Who does that?

about 2 years, said...

PARENT IN NURSING HOME LTC never never not go and check in middle of night, not enough staff be sure they are actually skilled staff. My parents feeding tube was cut 2 x and they will not admit who did it and the D O N was seen mortaring pills with apple sauce feeding tube started turning black inside had to have another procedure in hospital why did they not call DR in before it got this bad, you must go every day and always check the body complete for scars marks do the total bath yourself if you want to ensure your love one is totally clean and oral care never not ask questions we still do not have truth and answers.Wonders and alzh patients are always roaming no one watching them. Make sure LPN RN CNA are not leaving bed raise to hip or there will be falls or worst and EMT coming in all the time, make sure cleaning of rooms andn ot fancy shiny floors check for pest and bugs. ENSURE you love one is well fed and getting plenty of water if mouth is open to much they are starting to dehydrate. NEVER EVER trust staff that is not willing to review the records and medical charts When staff rush up to you and talking instead of washing hands wearing gloves and taking care of the residence patients they are stalling you so you will not see what they have NOT been doing, doing their jobs. They may not have enough staff which means neglected patients skilled quality care NEVER EVER NOT GO multi times and switch up times to see what is really happening in those places GO EARLY EARLY AM and check for beds cleaning of residence feeding times Ask for MEDICAL RECORDS meeting with Doctors in person Never let them just say same as stable what does same as and stable mean ask for vital signs DOCUMENT DOCUMENT JOURNAL JOURNAL GO ALL THE TIME never leave them with out family friends visitations NEGLECT MEDICAL MALPRACTICES ABUSE DE HUMANIZING really happens Elderly can not help they have incontinence issues they need RESPECT DIGNITY THEY HAVE RIGHTS TO LIVE HEALTHY AND SAFE ENVIRONMENTS Most treat dog kennels shelters better and the elderly

about 3 years, said...

My mother was transferred from a hospital to Saunder's House Rehab and Nursing Facility in Wynwood Pennsylvania in December. She stayed for 4 weeks to be rehabbed. I Was very skeptical about having her in any facility but it was necessary. What I experienced was exceptional care, nurses, physical therapist, social services, CNA's that were truely awesome. They went above and beyond to keep our mom safe, clean, and happy considering her circumstance. Beside her injury there was another kicker in her care she didn't speak English. Staff made sure her food was ordered, drinks were checked so that she was never thirsty. Amazing care from women who worked at 110% under emergencies that would arise and still run to make sure our most important family member in our life was taken care of.

about 3 years, said...

Do nursing homes have age restrictions, and if a person is 40 yrs old do they qualify for nursing home care? Is there programs out there to help a middle aged person with medicals issues? I have a 44 yr old person with lots of issues and needs 24 hrs care . Does Medicaid or Medicare help people in need or is this age restricted? If so, we need to stand up together to change the future for everyone in need ?

about 3 years, said...

Hello Julie krupp, I would encourage you to contact's team of Family Advisors. They may be able to help locate a housing option that meets your mother's needs. You can contact a Family Advisor, 7 days a week, toll free at (800) 325 8591.

about 3 years, said...

My mother is at Anchor Lodge currently in rehab. We are told that she needs 24 hour care and having someone come in every week paying 2500.00. They said if we cannot have someone stay with her we need to find another place. My sister has been looking constantly for a nursing home for her but no one will take her because in her records at anchor lodge they said she needs a place with a behaviorial section. This is not her problem. She has had a stroke and cannot walk and is in and out with remembering but is not a threat to herself or anyone. Maybe dementia because she is 86 years old. She does not need to be in a psychiatric ward and because of what they have in their medical notes no nursing home will accept her. We are at our wits end and don't know what to do and to find her a suitable place. It is tearing us apart. Any help or suggestions would be appreciated

over 3 years, said...

I was wondering if you later run out of money and need skill care what do you do in CA?

about 4 years, said...

Is there a standard for checking on memory care residents in SC? Mom fell out of bed and bled in the floor. We suspect no one checks on the residents from bed time to morning wake up call. She cannot care for herself or call out for help. In one month she has been bruised, scratched and has nail marks on hart arms. No records are kept as to staff rounds or incident reports.

almost 5 years, said...

Gave me direction and sorts of things to look for when I visit.

almost 7 years, said...

Hi mermaid5050, Thanks for sharing your thoughts about that facility. If you'd like, you can leave a formal review on our directory page for that facility, here: ( ). The more detailed your description the better, especially if you have personal experiences. Thanks again for sharing! -- Emily | Community Manager

almost 7 years, said...

I want to tell people,..that whitehouse country manor in whitehouse ohio ,is a bad facility to put a loved one in,,,they have kept me from seeing,calling and writing to her...all because my brother did not want me to have Power of attorney for my mom wanted to give me p.o.a . and my brother did not want to give up not do not put anyone in whitehouse country manor..........

about 7 years, said...

This was a good article. I did not have the option of reviewing all these items before my mother required nursing home care, as the situation came about suddenly. In addition to the items mentioned in this article, I suggest inquiring as to what security measures are in place to protect both the physical safety and privacy of patients. Though early on I was satisfied with the care received in the facility in which my mother was, a situation later arose with which I was very unhappy. The acute care unit seemed very on top of things, but when my mother was deemed to be not suited for further care and moved to the long term care unit, there were a number of patients who liked to "wander", and would turn up in others' rooms, and play with or take, or attempt to, other residents' property. What was really disturbing to me was when my mother's strength was all but gone, and I arrived for one of my daily visits to find another resident, probably twice Mom's size, at the foot of her bed, literally groping her feet while she slept. Unacceptable! The woman refused to leave, so I had to call the nurse. When I inquired as to what solution they were going to offer me so my mother would be able to rest as comfortably as possible for what time she had left, nobody could or would tell me what their security measures were.

about 7 years, said...

Thank you for a timely list. We've just started doing our homework in preparation for the time my husband needs more care than I can provide. I've been jotting down questions as I think of them and this is very helpful. Thank you Gayleen for adding your excellent question to the list. I think I would wonder if a place that doesn't allow 24/7 visiting is hiding something. And if I simply wanted to be with my hubby at 3:00 a.m., even to just watch him sleep, it would be good to know I could do that. The separation is going to be hard enough without being restricted to certain times only.

about 7 years, said...

This is a great list, but I would add one other. Definitely ask if the facility is open to visitors 24 hours a day. And if you want to show up at 2:00 am to check on your family member do you have to call and tell them or can you just show up? My mom is in a skilled nursing facility and I can just walk in anytime of the day or night. It makes me feel much more comfortable having my mom there knowing that if I have ANY concerns I can just "pop in" at any time to check on my mom.