Choosing a Nursing Home

Before placing a loved one in a nursing home, the first step is to decide what the long-term care needs actually are. In analyzing whether a nursing home is necessary, your loved one’s condition, wishes, and available support system should be evaluated. There are different levels of care, which are impacted by both financial and medical considerations.

Choosing a Nursing HomeYou can use our Free brochure: Guide to Choosing a Nursing Home to help make the best decision.

People face different circumstances in deciding when and how to place a loved one in a nursing home. In some instances, there is a good bit of lead time as an elderly person’s health deteriorates through dementia, diabetes or some other long-term disease process. In other instances, an elderly person may suffer an acute event, such as a stroke or a fall that requires placement after a short hospital stay. In either instance, it is important to develop a plan to evaluate both the appropriateness of a nursing home stay, the level of care your loved one will need, financial benefits that will pay for the care, your loved one’s physicians’ recommendations and location and qualifications of the facility.

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If your loved one is in a hospital, the hospital social services department is there to serve you and assist you in gathering information that you may need regarding potential nursing home placement. A family representative should also personally visit the facility and review appropriate documentation about the facility before making a decision.

Levels of Nursing Home Care

The different levels of care include Homecare, Daycare, Assisted-living, Nursing home care, Acute hospital care, and End-of-life hospice care.

Advocacy groups such as the National Citizen’s Coalition for Nursing Home Reform (NCCNR) can also provide you with assistance and information regarding nursing homes. Attorneys that handle nursing home litigation also tend to know the good nursing homes versus the bad.

Nursing home abuse and neglect can result in a variety of injuries and potentially fatal medical conditions. The Centers for Medicare & Medicaid Services (CMS) has defined “Never Events” as errors in medical care that are clearly identifiable, preventable, serious in their consequences for patients and indicate that a real problem in the safety and credibility of a healthcare facility.


Before deciding on a nursing home for a loved one, you should visit any facilities that you are considering. You can learn a great deal about nursing homes by visiting the facility and questioning and observing the staff. In addition to observing, you should interview staff members, residents and family members of residents.

The first visit should be scheduled and should include an escorted tour. At least one or two additional, unscheduled visits should be conducted, and they should be on different days and at different times of the day. Be present during at least one meal, preferably lunch or dinner, so that you can see how the staff interacts with the residents and whether there is adequate staff to manage the residents’ needs properly. Consider a weekend visit since that tends to be the time when the worst staffing problems occur. Take your loved one to the nursing home and allow him or her to evaluate whether he or she will be comfortable there.

Information Resources

You should look for the nursing home’s list of charges so that you can compare what they charge for various services. You should also determine whether your family doctor will continue to see your loved one at the nursing home and what he or she will charge. If not, you may be left to choose from one of the doctors on the nursing home staff. In that case, you should meet them and gather prices for services. You should find out from Medicare and Medicaid what they will pay for the nursing home placement.

You will want to investigate whether there are pensions, insurance coverage or other assets available to help to pay for your loved one’s care. Medicare has an 800 number and a website where you can compare nursing homes based upon their levels of licensure, staffing and some different characteristics regarding nursing home life. Florida performs nursing home inspection reports every 9 to 15 months. These are surprise inspections performed by a team of surveyors. The nursing home is then given a licensure rating, and any problems are identified in the inspection report. Florida law, the nursing home is required to make the most recent inspection report available in a public area at the nursing home so that it may be reviewed by patients and their families, or by any other person who asks for it. The level of staffing is crucial to proper care.