How to Choose a Nursing Home: A Step-by-Step Guide for Families
Whether you are planning ahead or facing a fast hospital discharge, choosing a nursing home comes down to a few objective checks plus what you see with your own eyes. Every Medicare-certified facility's inspection record is public — and it is the single most reliable signal of quality.
Step 1: Build a Shortlist by Location
Start with facilities within realistic visiting distance — frequent family visits are one of the strongest protectors of care quality. Use the skilled nursing facility finder to list every certified facility near you.
Step 2: Check Every Facility's Inspection Record
Look up each candidate's deficiency history on the free facility scorecard: total citations, severity levels, repeat citations, and whether problems were corrected. One clean facility nearby beats a highly-marketed one with harm-level citations.
Step 3: Screen Out Serious Warning Signs
- Recent Immediate Jeopardy citations (severity J, K, or L)
- Special Focus Facility status or candidacy
- Abuse or neglect citations (F600, F610)
- Repeat infection-control problems (F880)
Step 4: Visit in Person — Ideally Unannounced
Visit during a mealtime. Notice smells, call lights going unanswered, residents parked in hallways, and how staff speak to residents. Ask to see the most recent survey results — facilities are required to make them available.
Step 5: Ask About Staffing and Leadership
Ask how many RNs are on at night and on weekends, and how long the Administrator and Director of Nursing have been in place. High leadership turnover is one of the most reliable predictors of trouble.
Step 6: Compare Finalists Side by Side
Put your final two or three candidates next to each other with the nursing home comparison tool — deficiency counts, severity, correction rates, and your own visit notes — and involve the resident in the decision wherever possible.
Key insight: the tour shows you the facility on its best day; the inspection record shows you the facility on its worst day. You need both — and when they disagree, believe the inspection record.