Check for Cleanliness

A dirty facility is a warning sign. Check for cleanliness in common areas and resident rooms. Bathrooms, kitchens, counters, and other furnishing should be in good condition with no obvious stains. Do a spot check to see if bathrooms have adequate supplies, towels, toilet paper, and soap.

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Use Your Senses

Do more than just look around. Using your other senses, you can pick up on how nursing home facilities operate. For example, listen for bells that ring consistently. This might indicate understaffing, preventing staff from attending to resident needs promptly. 

Use your nose, too. Odd smells or strong odors may indicate poor hygiene or failure to follow regular cleaning regimens.

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Talk to Staff and Residents

Pay attention to how staff interacts with patients. Are they friendly and treat residents with respect? Talk to current residents to see how they feel about the quality of care, activities, and food. Do they seem happy, or are they withdrawn and sullen?

It’s important to engage with staff and residents, not just the tour guide, who will tell you all the positives about the facility.

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Look for Safety Systems

During the tour, take note of safety systems. This should include the following:

• Clearly marked exits

• Handrails in hallways

• Grab bars in bathrooms

• Security protocols for visitors

• Secure and monitored entrances and exits

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​Understand Visitation Policies

Ask about visiting hours and whether there are any restrictions for families. The more flexible the hours are, the more connected you can stay with your loved ones.

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Review Activity Calendars

Different residents will have varying medical conditions. Look for a variety of activities that match the interests and abilities of your loved ones. Social engagement is an important part of the quality of life. 

Sites like Facebook, Google, and Yelp often have nursing home reviews. However, to get a complete picture of a facility, only use them in conjunction with other research tools. 

Some sites allow nursing homes to delete reviews. In other cases, a few very good or very bad ratings can have an oversized effect on what are generally good overall ratings.

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Research Tools When Considering Nursing Homes

There are several online tools you can use when considering homes, including: 

• Medicare’s Nursing Home Compare Tool includes ratings, inspection reports, staffing levels, fines, and quality measures.

• U.S. News & World Report‘s Best Nursing Homes offers overall ratings, cost, and government inspection reports. 

• ProPublica offers a Nursing Home Inspection tool that compiles inspection reports, deficiencies, and fines. 

• Caring.com offers reviews, cost information, amenities, and pictures. You can also schedule some tours through the site.

• Glassdoor.com compiles employee reviews. It can give you insight into staff satisfaction, which can significantly impact the quality of care.

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5 - Review Options, Costs, and Contracts

An important part of how to find a nursing home is understanding the costs and options. Explore the financial details associated with nursing care—such as whether insurance coverage, Medicare/Medicaid assistance, or other financial aid is available. Depending on the ability to pay, there may also be a sliding scale of fees.

Many facilities offer different rates for different levels of care, so you will want to ensure you get the right type of care and can afford it. Other details to consider include the following:

• What additional cost might be charged, such as transportation or pharmacy fees

• Frequency of rate increases

• Upfront deposits and payment terms

• Options, such as private or shared rooms

If necessary, speak with financial or legal experts to help work through the financial impact.

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Nursing Home Red Flags

We rightfully expect nursing homes to be places of care, dignity, and safety. They are where some of the most vulnerable people seek comfort, support, and respect. Part of choosing a good nursing home is determining when they don’t meet those standards. 

Red flags to look for include:

• High staff turnover can disrupt continuity of care and indicate underlying management issues

• Lack of knowledge among staff about safety and care procedures, nursing home policies, and other critical matters

• Unsanitary living conditions with dirty or unsafe environments, such as soiled bedding or unpleasant odors,  inadequate housekeeping, poor lighting, and lack of privacy

• Poor personal hygiene in residents who appear unkempt or lacking basic hygiene can signal nursing home neglect

• A history of fines due to failure to meet state and federal regulations

• A designation as a Special Focus Facility by the Centers for Medicare & Medicaid Services is for nursing homes with ongoing, serious issues that could lead to loss of licensing and funding

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