How To Choose a Nursing Home or Other Long-Term Care Facility
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When an older person needs more help than a family member or friend can provide, it may be time to consider moving to a residential (live-in) facility, such as assisted living or a nursing home. Choosing a place to live for long-term care is a big decision. It can be hard to know where to start.
The following are some steps you can take to help find the right place for yourself or a loved one.
Consider the person’s needs and wants
What services are needed now and might be necessary in the future? For example, an older adult may need assistance with everyday activities, physical therapy, nursing care, hospice care, or a special unit for people with memory problems or dementia. If you are unsure, ask a health care provider which services may be most helpful.
What features are important to the person? For example, they may care about meals, social and recreational activities, a religious connection, or staying close to family and friends so they can easily visit.
Talk to friends, family, and others in your area
Ask about their experience with particular long-term care facilities. Were they happy with the care? Health care providers, social workers, religious groups, and support groups in your community may also be able to suggest quality places.
Call and visit different facilities
Once you’ve identified a few possibilities, get in touch with each place on your list. Ask questions about how many people live there and what it costs. Mention any special needs or preferences. Find out whether there is immediate availability or a waiting list.
Before deciding, it’s a good idea to visit several facilities in person. Make plans to meet with the director, nursing director, or other key staff members. Take a copy of the Medicare Nursing Home Checklist (PDF, 115K) to fill out during each facility’s visit. For example, look for:
- Medicare and Medicaid certification
- State licensing
- Accessibility for people with disabilities
- Residents who look appropriately dressed and well cared for
- Warm and respectful interaction between staff and residents
- A clean, fresh-smelling, comfortable, and well-maintained facility
Make a second visit without calling ahead. Try another day of the week or time of day so you will meet other staff members and have an opportunity to attend different activities. Stop by at mealtime. If there is a dining room, is it attractive and clean? Does the food look appetizing, and can you sample it?
Ask questions during your visits
Don’t be afraid to ask questions. Ask about anything that is important or concerning. Here are a few ideas for questions to ask the staff:
- How many care providers are there per resident? What kind of training do they have? How many of them are trained to provide medical care if needed?
- How long have the director and heads of nursing, food, and social services departments worked at the facility? How often do key staff members turn over?
- Is there a doctor who checks on residents on a regular basis? How often?
- What activities are planned for residents during the week and on weekends? Can you attend activities yourself to see what they’re like?
- Is there a safe place for residents to go outside?
- How do residents get to medical appointments?
- If you need it, does the facility have a special unit for people with Alzheimer’s disease or another form of dementia? If so, what kinds of services does it provide?
- Is there information on state regulations for how care is provided? For example, what happens when there is an infectious disease outbreak requiring quarantine?
Find out about costs and contracts
Each facility is different, so get detailed information about costs and which services are included. Find out if Medicare, Medicaid, or long-term care insurance will pay for any of the costs. The facility may have a financial office that can help you determine what assistance is available. Learn more about paying for long-term care.
Once you select a facility, read the contract carefully. Make sure all the agreements are clear and ask questions about anything you don’t understand. Read over the contract again before signing it.
Resources for choosing a long-term care facility
Do you want to learn more about the options for long-term residential care? These resources can help you get started:
- Search the Eldercare Locator or call 800-677-1116 for help finding care in your area.
- Visit LongTermCare.gov for information about housing options for older adults and finding local services.
- Call your local Area Agency on Aging or department of human services from your state or local government.
- Use Medicare’s Care Compare tool to find and compare nursing homes and other health care facilities in your state or territory.
- Check the quality of nursing homes and other health care facilities with the Joint Commission’s Quality Check.
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This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.
October 12, 2023