What Should I Look for when Visiting a Prospective Nursing Home?

The process of choosing a nursing home for your loved one-particularly a skilled nursing facility that will be providing vital medical care-requires careful attention. With over 16,000 nursing homes in the U.S., you are likely to have many options to choose from. Once you have narrowed the list of candidates to two or three, the final step in the evaluation process is to visit each facility. This guide will examine some of the things you should consider during your visit.

Your first visit to a skilled nursing facility should be scheduled. Call the facility and make an appointment for a tour. Late morning, midday, or early afternoon are ideal, since most residents will be awake and moving around, and some of the social and recreational activities should be underway. This will give you a snapshot of daily life at the facility.

In most cases, a member of the staff will guide your tour and can answer any questions you may have. Don't be embarrassed or hesitant about questioning anything you may see or hear! If there are areas that you would like to see but that aren't included on the tour, be sure to ask your guide to show them to you.

Try to schedule the appointment during a meal time-probably lunch-and ask to eat in the dining facility while you're there. The quality of food service is obviously an important consideration since your loved one will be spending at least a number of days in the facility with few options for outside dining, and your meal will give you the opportunity to see the variety and quality of food as well as the condition and cleanliness of the serving line and dining area.

It's a great idea to talk to some residents and, if they're available, family members of residents about the facility. Find out how long they've resided at the facility and what their experience has been. Be sure, however, not to enter anyone's room without first getting permission from both the resident and the staff.

Try to arrange an opportunity to sit in on a meeting of the resident council and/or family council if the facility has one. This will give you more chances to talk to those already staying at the facility. Keep in mind, however, that one of the main purposes of these councils is to address any complaints or problems at the facility, so much of what you hear during the meeting may be negative. While you should be wary of serious, substantiated problems or an apparent history of failing to resolve ongoing issues, be careful not to let attendance at these council meetings give you a distorted image of the facility.

At the end of your first visit, ask your guide about the best person to contact in the event you have further questions. As you have time to reflect on your visit, you may find that you have additional questions. Make a list of these and after a few days, call the contact person to get answers.

You should make another unscheduled, unannounced visit to the same facility several days after your scheduled visit. (If the nursing home has a "no drop-in" policy that prohibits this, take that into careful consideration when making your final decision.) Your visit should be on a different day and at a different time of day; weekends are an excellent choice because staffing levels may be lower than during the week. You'll be looking at many of the same things you addressed on your first visit, but this time you want to see how things look when no one was expecting visitors. In a quality skilled nursing facility, you should see little difference between the first and second visits.

In order to get the most value out of your visits and ensure that you don't miss important aspects of your evaluation, as well as to ensure that you evaluate different facilities in an equal manner, print a copy of our "Skilled Nursing Facility Evaluation Visit Checklist" to take with you on each of your visits.