Nursing Home Review

When you make the decision that it will be necessary for your loved one to enter an assisted living facility or nursing home, you are going to want to make sure they are going to the best possible facility with the best ratings.

This is how you should go about checking out nursing homes for your loved one. 

First of all, pick a nursing home or assisted living facility that is convenient for you. It should be at a reasonable driving distance from your home, if possible.

The way to do this general search is to start online with two great websites: 

  • Eldercare Locator , from the Department of Health and Human Services, and…
  • Nursing Home Comparison from the Official Government site on Medicare. Both tools will allow you to access Medicare and Medicaid certified nursing homes. 


How To Review A Nursing Home Online



The search parameters vary between the sites, but will allow you pick up a special facility based upon the unique symptoms your loved one is experiencing (ie: Alzheimer’s, dementia, diabetes, etc…) within a specified geographic area (state, county, zip code). 

In addition, you need to be aware of the payment options that are available. Most nursing homes do take Medicaid, but the application process can take months.

This is why if you are in the process of applying for Medicaid you must check with the admissions office to make sure that the nursing homes you are looking at accept “Medicaid pending” patients. What this means is that the nursing home is willing to wait for payment from Medicaid. 

Now, after the search results are displayed through the online locator’s, you will have access to a wealth of information about the facility, including… 

  • Name, address and phone number for each facility matching your search criteria.
  • Initial date of certification
  • Type of ownership (for profit, non-profit, etc)
  • Do they take Medicare/Medicaid as payment or are they private pay.
  • Quality ratings for the staff and health inspections 

Use this information as the first step in the process of determining the three or four facilities you are going to visit in order to make a final decision for your loved one. 

Depending upon the situation, you may also have access to a social worker who may be able to guide you through this process. 

When my mother fell and was in the hospital, I received plenty of support and feedback from the social workers at the hospital she was receiving care in. They helped me to pick the right facility close to me with a good reputation and quality control where she stayed until she was able to come home. So if you have access to such advice, use it. 

Now that you have narrowed your choices to the three of four facilities that will fit the needs of your loved one, you now need to make arrangements to visit them. As you go on the tour, you need to be like a sponge, absorbing as much information as you can and being as observant as you can.

Whoever is taking you on the tour will undoubtedly be highlighting the good points of their facility. But these are some of the things that you want to be watching for… 

  • Is the staff pleasant with the patients at the facility? Do they treat the residents with dignity or like children?
  • Does the staff seem like they care or is this just a job?
  • Does the staff know the names of the residents?
  • Did the staff greet you as you entered the facility?
  • Does the staff appear rushed? Or are they working at a pace that appears calm and steady.
  • Take a moment and listen. Do you hear any laughter? How about friendly conversations between residents?
  • Are the residents clean and well groomed? Is their home combed? Are their nails clipped?
  • Are residents allowed to move about the facility?
  • Observe how quickly it takes for the staff to respond to call lights and buzzers. If they cannot respond quickly enough in the daytime when you are taking the tour, imagine how long it will take at night when they aren’t as well staffed. Typically, a ‘good’ response time is under 5 minutes.
  • Look for the proper use of safety equipment, such as handrails in the hallways and the bathrooms. In addition, rooms and hallways should be well lit and rooms should be uncluttered.
  • Observe the smell of the facility. Does it smell like it’s been cleaned regularly or does it smell like human waste.
  • Try and sample a meal from the kitchen if possible. Does, for example, the pizza taste like pizza…or egg noodles and ketchup on dried cardboard. I am not telling you to expect a seven course meal but you do want quality and nutritious meals for your loved one. 

And here are some questions for the facilities administrators: 

  • What is the turnover rate for the staff? Retention of the staff means that the residents have the same aides over and over, building a level of familiarity and trust between staff and resident.
  • If your research came up with any potential red flags or violations, even if they were fixed, ask. You are putting the administrators on notice that you have done your research.
  • Are nurses available 24/7 including holidays?
  • Do residents have a say in who their roommate is, if they are in a shared room?
  • Ask for the facility’s most up-to-date survey report. Every Medicare/Medicaid facility submits to this inspection once a year. It is an unannounced visit and a thorough inspection of every aspect of the facility, normally taking 3-5 days to complete. All violations will be noted in the report. (NOTE: There is no facility out there that is perfect. Almost all inspections find some form of violations. Some may appear mundane. But pay attention to the one’s that appear to put resident safety at risk.

What is the staff-to-resident ratio at the facility? This is a indicator of the quality of the care that your loved one will receive. Here are acceptable levels of nurses aides to residents:

A. Night shift: One aide for every 14 patients

B. Evening shift: one aide for every 10 patients

C. Day shift: one aide for every 6 patients 

Finally, as you leave the facility, just ask yourself, “Would I want to spend the last years of my life here?” And the answer to that question will determine whether or not this is the place for your loved one.

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