Choosing a nursing home for a loved one can be one of the most stressful things you will ever have to do. Your support and care are important to help the person adjust to having to move into a long-term care facility. Include the person you are helping in the decision-making process whenever possible. If they feel decisions are being made with their needs and preferences in mind, it will make the process easier for everyone involved.  

Paying for nursing home care is the first consideration to be made. It’s important to know that Medicare does not cover long-term care in a nursing home. Short-term rehabilitative care after a hospital stay is covered by Medicare, but not nursing home residency. Room and board in a nursing facility is paid from personal resources, long-term insurance, state government or Medicaid if the person is eligible. Check with the U.S. Centers for Medicare & Medicaid Services (CMS) for more information on paying for nursing facilities. If the elderly person has a Medicare health plan, coverage will continue for doctor visits, hospital care, and prescription drugs while living in a nursing home.

The Centers for Medicare & Medicaid recommends the following guidelines for choosing a nursing home:

Make sure the nursing home is Medicare- or Medicaid-certified, and that it provides the level of care you need, either skilled or custodial. Also make certain the facility has necessary services available in case of dementia, or for rehabilitation. Choose a nursing home that is located near friends and family.

Visit the facility on separate occasions and note if the residents are clean, well groomed and appropriately dressed. The facility itself should be clean, well maintained and free from unpleasant odours. The air temperature should be comfortable; all areas should be well lit, and noise levels in common areas like the dining room should be pleasant. Smoking should be limited to specific areas.  Furnishings should be attractive and comfortable.

Note the relationship of the staff to residents; is the atmosphere warm and polite? The staff should wear name tags and be courteous at all times, address residents by their names and knock before entering a person’s room. Nursing staff should be on duty 24 hours a day, 7 days a week. A registered nurse (RN) should be on call at least 8 hours every day, along with a full-time social worker, and a licensed medical doctor who can be reached around the clock. Ask if the nursing home does background checks on all staff, including maintenance workers.

Residents should be able to keep personal belongings, including furniture, in their rooms. Closet and dresser should provide ample storage space. Every bedroom should have a window. Residents should be able to choose their roommates and have access to a personal telephone and television.

There should be a choice of food at each meal, and snacks should be available when desired. If help is needed at mealtime, staff should assist with eating and drinking.

A variety of activities should be provided on a daily basis, even for those who are unable to leave their rooms. Outdoor areas for fresh-air activities should be available year-round and staff should be on hand to help residents go outside.

Make sure residents get preventive care such as a yearly flu shot and dental visits. Residents should be able to see their private physician and the nursing home should provide transportation. Ask what arrangements the nursing home has with a nearby hospital in case of an emergency. 

Arrange regular meetings with staff to discuss your relative’s needs and care. Make sure friends and family members can visit frequently and unexpectedly. There should be regular and frequent communication between staff and family of the resident.  Finally, trust your instincts. If you didn’t like what you saw on a visit, say, the facility wasn’t clean or you were uncomfortable talking to the staff, you might want to consider another nursing home. Take time to find the right facility for your loved one and your own peace of mind.