Free checklist · for families
Questions to Ask a Nursing Home
Nursing homes are the one kind of senior care with a national report card, so the best questions start before you walk in the door. Look up the ratings and inspections first, then use the tour to ask about what the numbers can't show: who is on duty at night, how the care plan gets made, and what your parent's days will hold. Each question comes with what a good answer sounds like. The printable checklist has room for three places side by side.
What nursing home is, in one paragraph
A nursing home provides 24-hour care from licensed nurses, for short-term rehabilitation after a hospital stay or for long-term care. Homes that take Medicare or Medicaid are federally regulated and inspected, and their results are public.
Before you tour
- Look the home up on Medicare's Care Compare website (medicare.gov/care-compare). Note the overall star rating, and look separately at the staffing and health inspection ratings; one good star can hide two weak ones.
- Read the most recent inspection report. The home must keep it where visitors can see it, and you can ask for it on the tour.
- Call your state's long-term care ombudsman about complaints. It's free; the Eldercare Locator (1-800-677-1116) will connect you.
The 17 questions to ask
Under each question: what a good answer sounds like. Write down what they actually say; the checklist has a line for it.
Staffing
- How many nurses and aides are on duty on day, evening, night, and weekend shifts?A good answer: Numbers for each shift, including weekends, which is where staffing is thinnest.
- How much do you rely on agency or temporary staff?A good answer: An honest share. Heavy agency use means residents see strangers.
- Will the same aides care for my parent most days?A good answer: Yes, consistent assignment, so someone knows how your parent likes things done.
- How long have the administrator and director of nursing been here?A good answer: Years, ideally. Frequent leadership changes often show up in inspection results too.
Care
- When is the first care plan meeting, and can we attend?A good answer: A date within the first weeks, with the resident and family invited, and regular meetings after that.
- How often does a doctor or nurse practitioner see residents?A good answer: A regular schedule and a clear answer on who comes when something changes.
- How do you prevent falls and pressure sores?A good answer: Specific routines: turning schedules, checks, equipment, and how they're recorded.
- How are antipsychotic medications used and reviewed?A good answer: Rarely, after other approaches, with regular review and the family told first.
- Is therapy (physical, occupational, speech) available on site?A good answer: Yes, with a description of how often a resident can be seen.
Medicare, Medicaid and money
- Is this bed for short-term rehab or long-term care, and will my parent need to move rooms?A good answer: A clear answer. Medicare covers a limited stay of skilled rehab after a qualifying hospital stay; it does not pay for long-term custodial care.
- Is the home certified for Medicaid, and will my parent keep their room if they move from private pay to Medicaid?A good answer: Yes to both, with the policy for residents whose Medicaid application is still pending.
- What does the daily rate include, and what is billed separately?A good answer: A written list: laundry, hair appointments, supplies, phone, cable.
Daily life
- Can I see this month's activity calendar, including evenings and weekends?A good answer: Activities every day, weekends included, with programs brought to residents who stay in their rooms. Federal rules require an ongoing, individualized activity program.
- What is done for residents who can't leave their rooms?A good answer: Planned one-to-one visits written into the care plan, not just the television.
- How are roommates matched, and what happens if it doesn't work?A good answer: A described process and a way to request a change.
- How quickly are call lights answered, day and night?A good answer: A target time and a way it is checked.
- What can my parent bring from home?A good answer: Photos, a favorite chair, their own bedspread, labelled clothing.
What to check with your own eyes
- Watch the call lights in the hallway. How many are on, and for how long?
- Visit a second time without an appointment, on a weekend or in the evening.
- Notice whether residents are up, dressed, and out of bed by late morning.
- Eat a meal or watch one served. Is help given to those who need it, and is the food still hot?
- Look for residents taking part in something, and for staff talking with residents rather than about them.
Red flags
- A low staffing star on Care Compare with no explanation.
- Recent inspection problems nobody mentions on the tour.
- No clear answer on keeping a resident after they switch to Medicaid.
- Lots of call lights on, and nobody hurrying.
Take the Nursing Home checklist on the tour
Every question above in large print, with a line for their answer, a what-to-look-for page, and a sheet to compare three places side by side. Free, plus one useful email a month. Unsubscribe anytime.
After the move: the visits
Whichever place you choose, the visits are what make it home. The first few are the hardest to fill. A handful of conversation starters or a page of trivia from their young years gives you something to do together besides asking how the food is.
