What to look for in a Nursing Home


Use the following checklist to assist you in assess nursing homes. If possible, both the caregiver and care recipient should be involved in the decision making process. The more an older person participates in the planning process, the easier it will be to adjust to the new environment.

The Facility

  • Are there handrails along the walls?

  • Are the doorways wheelchair-accessible?

  • Does management take safety precautions to prevent residents from falling down stairs?

  • Is the floor kept dry and free of litter?

  • In case of fire, can the facility be easily evacuated?

  • Are fire extinguishers easy to locate?

  • Does the facility appear clean?

  • Are there lingering odor?

  • Do the faucets, call buttons, telephones, and television sets work?

  • Are heating and cooling adequate?

Staff and Care

  • Is the atmosphere pleasant?

  • Do staff seem to genuinely enjoy working with the residents?

  • Do staff appear to care about and respect residents?

  • Are residents treated as individuals?

  • Do the staff appear interested in the residents?

  • Do staff seem interested in speaking to visitors or residents?

  • Are your questions answered clearly, frankly, and in sufficient depth?

  • Do any other residents have conditions similar to your elderly relative's?

  • Are residents clean and adequately dressed?

  • Do staff appear to refrain from making unrealistic promises or predictions?

  • Are the rights of the residents clearly posted?

  • Is the food hot, attractive, and tasty?

  • Are special diets available? What kinds?

  • Does a resident have plenty of drinking water easily available?

  • Are planned, posted, and varied recreational and social activities available?

  • Do the listed activities seem interesting and appropriate?

  • Do most of the people at an activity program seem to be participating?

  • Are religious services held weekly?


  • Is the facility in good standing with the state inspectors?

  • Are fees competitive?

  • Have fees increased significantly in the past few years?

  • Is the structure easy to understand and reasonable?

  • Does the institution readily reveal what service are covered in the quoted fee?

  • What services are extra?

  • Is Medicaid accepted? Is Medicare accepted?

  • Are billing and accounting procedures understandable and acceptable?

  • Is transportation of patients provided?

  • Does a resident advisory council exist?

  • Are visiting hours reasonable?

  • Are therapeutic services available? (Speech, physical and occupational)

  • Are social work services or other mental health services available?

  • Are community organizations (library, church group, volunteers) involved?

  • Do the charge nurses, social workers, department heads, and top-level administrators have geriatric experience and/or education?

What to Look for in Assisted Living Communities

Using the following checklist to assist you in assesses assisted living communities. If possible, both the caregiver and care recipient should be involved in the decision making process. The more an older person participates in the planning process, the easier it will be to adjust to the new environment.

Assessing an Assisted Living residence as you tour the facility:

  • As you arrive at the residence, do you like the location and outward appearance of the residence?

  • As you enter the lobby and tour the residence, is the decor attractive and home-like?

  • Did you and your potential resident both receive a warm greeting from staff welcoming you to the residence?

  • Does the administrator/staff call residents by name and interact warmly with them as you tour the residence?

  • Do residents socialize with each other and appear happy and comfortable?

  • Are you able to talk with residents about how they like the residence and staff?

  • Do the residents seem to be appropriate housemates for your loved one?

  • Are staff appropriately dressed, personable and outgoing?

  • Are the staff members that you pass during your tour friendly to you?

  • Are visits with the resident welcome at any time?

  • Is the community well-designed for resident's needs?

  • Are the recreational and non-living spaces free from storage items or other obstacles?

  • Is the floor plan easy to follow?

  • Are doorways, hallways and rooms accommodating to wheel chairs and walkers?

  • Are elevators available for those unable to use stairways?

  • Are hand rails available to aid in walking?

  • Are cupboards and shelves easy to reach?

  • Are doors of a non-skid material and carpets firm to ease walking?

  • Does the residence have good natural and artificial lighting?

  • Is the residence clean, free of odors and appropriately heated/cooled?

  • Does the residence meet local and/or state licensing requirements?

  • Needs assessments, contracts, costs & finances

  • Is there a written plan for the care of each resident?

  • How long after admission is this care plan written?

  • Are the family and resident involved in writing the care plan?

  • What is the procedure for assessing a potential resident's need for services and are those needs reassessed periodically?

  • Can a resident be discharged for refusing to comply with a care plan?

  • When may a contract be terminated and what are refund policies?

  • Are there any government, private or corporate programs available to help cover the cost of services to the resident.

  • Is a contractual agreement available to include accommodations, personal care, health care and supportive services?

  • Are additional services available if the resident's needs changes?

  • Are there different costs for various levels or categories of services?

  • How do you pay for additional services such as nursing care when needed on a temporary basis?

  • What are the billing, payment and credit policies? May a resident handle their own finances with staff assistance if able, or should a family member or outside party be designated to do so?


  • What is the policy on insurance and personal property?

  • Is staff available to meet scheduled and unscheduled needs?

Medication/health care

  • What is the residence policy regarding storage of medication, assistance with medications, training and supervision of staff and record keeping?

  • Is self-administration of medication allowed?

  • Who coordinates home care visits from a nurse, physical therapist, occupational therapist, etc. if needed?

  • Are staff available to assist residents who experience memory, orientation, or judgment losses?

  • Does a physician or nurse, visit the resident regularly to provide medical checkups?

  • What is the procedure for responding to a resident's medical emergency?


Is staff available to provide 24-hour assistance with activities of daily living (ADL) if needed?

ADLs include: __Dressing __Eating __Mobility __Hygiene and grooming __Bathing, __toileting __incontinence __Using the telephone __Laundry __Housekeeping in unit __Transportation to doctor, hairdresser, activities, etc. __Shopping __ walking/caring for pets. others:______________

Features of individual units

  • Are different sizes and types of units available?

  • Are units for single and double occupancy available?

  • Do residents have their own lockable doors?

  • Is a 24-hour emergency response systems accessible from the unit?

  • Are bathrooms private with handicapped accommodations to accommodate wheelchairs and walkers?

  • Are residents able to bring- their own furnishings for their unit and what may they bring?

  • Do all units have a telephone and cable TV and how is billing handled?

  • Is a kitchen area/unit provided with a refrigerator, sink and cooking element?

  • May residents keep food in their units?

  • May residents smoke in their units? In public spaces?

  • May residents have pets?

Social and recreational activities

  • Is there evidence of an organized activities program, such as a posted daily schedule, events in progress, reading materials, visitors, etc?

  • Do residents participate in the neighboring community?

  • Do volunteers, including family members, come into the residence to help with or conduct programs?

  • Does the residence require residents to undertake any chores or perform specific activities that benefit all residents?

  • Does the residence have its own pets or provide for pets to visit the facility?

Food Service

  • Does the residence provide three nutritionally balanced meals a day, seven days a week?

  • Are snacks available?

  • May a resident request special foods?

  • Are common dining areas available?

  • May residents eat meals in their units?

  • May meals be provided at a time a resident would like or are there set times for meals?


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