December 3, 2014

How to choose a nursing home, part 1

When you have a parent or elderly relative who exhibits diminished mental or physical capabilities, family members start talking quietly about mom or Uncle Bill. Although this person may not need long-term or nursing home care for some time to come, now is the time to be proactive and begin the conversation about long-term care.

I know, this is a difficult thing to do. But the key advantage to being proactive is that when you get the facts and learn what you need to know upfront, it prevents making a reactive, hasty decision when the time does come.

So, for the next few posts, I am going to talk about how to select a nursing home. It’s a big decision, but if you ask the right questions and use the checklists I’ll provide, you can more easily make an informed decision that’s right for your loved one and the entire family.

Let’s start with three essential questions to ask and consider that concern you, family members, and the “resident” to be –

  1. What are the resident’s current and potential care needs? Will the facility be able to consistently meet those needs over time?
  2. How close is the facility to doctors and family? Will appointments and visits be convenient?
  3. Do you feel confident and comfortable when you walk through the doors? While no facility can be as warm and familiar as home, sometimes you just know when you’ve found the right place.

Once you’ve addressed these questions and answered them, you can move on to more specific inquiries, such as these, grouped by three key topic areas –

Quality Of Care And Life

  • Is the environment pleasing?
  • Is staff attentive, positive and respectful of both guests and residents?
  • Are residents treated as individuals?
  • Are questions answered clearly and completely?
  • Are residents clean and appropriately dressed?
  • Are the rights of the residents clearly posted?
  • Are there adequate recreational and social activities available?
  • Are religious services held consistently?
  • Are visiting hours reasonable?
  • Are speech, physical and occupational therapy services available?
  • Are social work services available?

Comfort And Safety

  • Are there handrails along walls?
  • Does the facility appear clean and free of odors?
  • Is the floor kept dry and free of litter?
  • Are fire extinguishers easy to locate?
  • Are there enough choices for quiet and active areas?
  • Is the temperature comfortable throughout the facility?
  • Is the food appetizing and enjoyable?
  • Is water available and easily accessible?

Management And Costs

  • Are fees competitive and relatively stable?
  • Is it clear what is included and not included in the fees?
  • Are Medicaid and Medicare accepted?
  • Are billing and payment terms reasonable?
  • Is transportation available for residents?
  • Do residents and family have a say in their rights?
  • Do senior staff and top-level administrators have geriatric experience?
  • Is the staff comprised of any temporary or contracted agency personnel?

In the next post, I’ll add some commentary about these questions in terms of what constitute good answers, as well as extending topic areas and questions you should ask.

Thanks for reading and, as always, if you have comments or questions, please e-mail them to me at

Robert W. Hurlbut, President