Nursing homes, or Skilled Nursing Facilities, are an option for people who don’t necessarily require hospitalization or round-the-clock supervision and care, but need some medical or physical therapy assistance, or special care after surgery or during illness. Some nursing homes are set up as a hospital type of environment, while others are designed like homes or assisted living units. So once you know the basic criteria of what you’re looking for, here are some ideas to help you go about choosing the right facility for what you need:

Consult Your Hospital/Healthcare Provider

Hospitals usually employ social workers or hospice/assisted care advisors who likely have a list of skilled care facilities. Talk to friends, family, social/religious groups, and even family members who have loved ones in care. They can help you pick out some places and offer insight and recommendations.

Call Your Preliminary List of Options

– How many residents do they have?
– Is there a doctor on call, or do residents travel to see a physician?
– Is the schedule regimented, or more flexible?
– How many staff members are there? How many nurses or specialized personnel?
– What was the facility’s last evaluation rating? How were problems handled?
– What is the rate of turnover for both staff and residents?
– What is the basic fee structure; can you afford it?


Once you have narrowed down your list of potential facilities, ask for an appointment. You can get a first-hand look at the operations and make your own observations. Some suggestions:

– Check for safety hazards: some of these aren’t always obvious, like frayed carpets, for instance, or cracks in the floor. Also keep an eye out for raised doorsills, uneven tile or floorboards, electrical cords, and unusual bevels or bumps.

– Observe how the nurses/aides interact with people; do they address residents by name? Do they knock before entering the room? Do they know the resident’s habits, interests, schedule, and family names? Does the staff make sure that residents are stimulated and provided opportunities for activity and interaction, or are residents left alone for long periods of time?

– Cleanliness and safety of the facility: are the floors and surfaces clean and well-kept? Are the doors and windows equipped with locks or alarms? Are there cameras and/or other surveillance features? What is the facility’s current safety evaluation?

Visit Again

This time go to the facility unannounced, without calling ahead – perhaps a few days later, and try a different time of day so that you can observe other staff at work. Pop in during lunch and observe how mealtime is handled. How does the food look? How is it served? Is it nutritious and easily digestible? Are residents given the option of eating their own food preferences, and does the facility oblige religious dietary requirements, etc? Do staff interact with or sit with residents during mealtime and engage in conversation?

When You Choose

Ultimately, cost is going to be a big factor in your final decision, as well as quality of care and medicine. If there’s something you don’t understand, ask the facility director for clarification, and keep asking until you’re satisfied with the explanation.

You can find a list of skilled facilities that have been approved by the Centers for Medicare and Medicaid Services (CMS), as well as a checklist of additional questions, at

There are also many available State Insurance Assistance Programs that can help you with choosing health insurance and finding other financial aid: (link to

Other Links:

Dept. of Veteran’s Affairs:
National Long-Term Care Ombudsman Resource Center: