October 6, 2000
Choosing A Nursing Home-Part II
By: Gail R Mitchell 

The more you research, the more you will be able to 
make a better, more informed decision.

Considerations to look for when choosing a nursing 
home:

 
Location- is the home a reasonable distance from 
your home? By being close, visiting will be easier. Do 
you have accessible transportation to the home? 
What are the visiting hours? How do they fit into 
your schedule? 
What kinds of activities are provided for the 
residents? What types of activity rooms are available for 
recreation? 
Are there safe areas and gardens for walking and 
sitting outside? 
What is the physical layout of the facility like?

Is it attractive? 
Is it well organized? 
Is it designed for the privacy needs of the 
patient? 
What are the ratios of patients to staff? 
Is the staff welcoming and responsive? 
Is the level of hygiene maintained - the cleanliness 
of rooms and hallways. 
What is the quality of food like? 
 

Are the foods nutritious, and 
geared towards the patient's individual needs? 
Is assistance available if the patient needs 
to be fed? 
Are snacks and proper foods available in 
between meals? 
Can residents choose their own menu? 
Is the kitchen clean? 
Are dishes, pots and pans clean? 
Are there bugs? 
What are the resident's rooms like? 
How are they furnished? 
Are they warm and comforting? 
Can you bring in your own bed and 
furnishings? 
Is there storage for the patient's belongings? 
Can personal items be brought in to create 
an environment that is comfortable for them? 
Are these personal items safe? How is the 
theft of personal possessions handled? 
Does the room have an emergency system to 
call for help? Are they working properly? 
Does each room have it's own bathroom and 
is it clean? 
Does it have the proper hand rails, grab bars 
and accessories your loved one will need? 
If patients share rooms with another 
resident, how are problems handled? 
How accessible are bathrooms outside the 
patient's own room? 
Is there a phone in the patient's room or nearby for 
personal use? Can those with wheelchairs reach the phone? 
Is there a television and radio in the room if the patient 
is bedridden? What if the patient prefers to just watch TV or 
listen to the radio on their own in the comfort of their room? 
Are personal services available i.e., hair cutting, washing 
and tailoring? 
How are ingoing and outgoing personal mail services 
delivered? Are postage services for mailing available? 
Who is responsible for shopping for the personal needs 
of the resident? 
Are pets allowed and how is this handled if they are? 
How is cash handled for the resident's incidental needs? 
Are all entrances, exits, rooms, and hallways and elevators 
wheelchair accessible, and walker accessible and does the 
width meets the needs of the patient's means for getting 
around? 
Is smoking regulated? 
Are exits marked and not blocked? 
Are the floors slippery? 
Are heating and cooling systems adequate and 
working properly? Does the resident have individual control 
of the heating and cooling systems in their room? 
Are floors, sidewalks and ramps smooth to prevent 
tripping and falling? 
How frequent are linens changed? 
How are resident's personal laundry needs handled? 
How does the facility involve the family? 
Is there professional support one on one or are there 
support groups? 
How are the resident's spiritual and religious needs met? 
Are there periodic meetings scheduled between the 
care team and the family members? How often are they? 
How are family members informed of their loved 
one's status and how often? 
If your loved one has Alzheimer's observe and check 
out the following: 
(In terms of Alzheimer's patients, 
the need for placement will require that special 
needs be met daily by the facility. Many homes 
now have separate Alzheimer's units with 
specialized care. Some may even offer therapeutic 
programs for the family members as well). 
You will want to check out how the staff 
interacts with these patients. 
How knowledgeable and trained are the 
physicians with Alzheimer's, the current 
medical technology etc? 
Is the staff trained with the specific dietary, 
activities and other problems and needs arising 
with the patient? 
What safety precautions are taken in case 
they wander off and hurt themselves? How are 
they monitored? 
Is there confusion and lots of noise in the 
unit, possibly indicating a lack of control and 
supervision on the part of the staff? 
How are medications and physical restraints 
used in behavioral management? (Remember 
there are laws governing these restraints. The 
family must give permission and certain forms 
are illegal. No one can be restrained 24 hours 
a day.) 
Speak with other residents and their families 
if possible, to view things at the nursing home from 
their perspective. 
Observe other residents? 
Do they have bruises on their faces, arms 
or legs? 
Are they dressed properly? 
Are they occupied, or are they wandering 
aimlessly in the halls or left sitting all alone? 
Are there odors in the hallways and communal 
areas? 
Are smoke detectors and fire extinguishers working 
and visible? 
Are calls for assitance promptly answered both day 
and night? 
Is there a physician available for emergencies at 
all times? 
Where and what is the nearest hospital? 
Will the home take the patient 
to the hospital from the facility if needed? 
Will the hospital be able to provide the care 
that your loved one might need? 
Visit all facilities unannounced. Try to do 
this when there aren't visiting hours. 
Is there a family council that meets to handle 
complaints? 
What types of admission plans are available? 
Single rooms? Shared rooms? 
Is there a waiting list? 
Do a complete background check on the facility: 
i.e., ownership, management, financial stability, and 
staff qualifications. You can check with the Chamber of 
Commerce, the Better Business Bureau and your state's 
department of health. 
Use the services of an ombudsman. (An 
ombudsman is an advocate for the residents). They 
can find out about past complaints and lawsuits 
against the nursing home. 
Make sure the facility has complied with all state 
licensing and accreditation requirements. 
Is there an admissions fee in addition to the 
regular monthly charges? 
Get a copy of the last inspection report for the 
facility. 
Get written copies of all oral agreements or promises. 
Request a copy of the resident's bill of rights. 
Under the Federal law, all nursing homes must have a 
written description of the rights of the residents and it 
must be made available to the resident or family member 
who requests it. 
Does the facility accept benefits from Medicare, 
Medicaid and the Veterans Administration? 
What are all the financial costs involved? 
Is the fee daily or monthly 
and how much is it? How are extra needs met? 
What payment options are available? 
What is and what is not included in the 
monthly costs? 
What services are available for extra charges? 
What is the policy regarding daily or 
monthly rate increases? When was the last one 
done? What was the last increase? 
How much notice is given regarding an 
increase and how are they informed? 
Under what conditions are refunds 
made available to the resident? How much 
notice is needed? 
How long does the home hold a room 
if a resident needs hospitalization? 
How often are the families informed of 
the status of the resident? 
Will our loved one need their own aid or nurse 
24 hrs within the facility in addition to the home's staff? 
Meet with the administrator to ask important 
questions you may have. 
What grounds are cause for the contract to be 
canceled? 

Before signing any agreements, have an attorney 
review the contract, the small printed matter and 
the rules and regulations of the facility.

With proper research and preparedness, you can be 
reassured that you will find the proper home that 
meets the need of your loved one and their family. 
It is important to stay involved and oversee that the 
home is maintaining the quality of life for the patient. 
Many times it is important for the patient to see familiar 
faces as they can become disoriented when the transition 
is made into a home. Close monitoring on your part will 
assure your loved one receiving the best care. 

Richest Blessings, 

Gail



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