How to Choose a Nursing Home: Practical Checklist

Start with care needs and location

Define the required level of care before comparing star ratings. Ask the hospital discharge team or clinician whether the person needs short-term skilled rehabilitation, long-term nursing care, memory support, dialysis coordination or another specialized service. Confirm that each facility can meet those needs and has an available bed.

Build a shortlist from public evidence

1. Compare CMS ratings: inspect the overall, health, staffing and quality-measure scores separately.
2. Read inspections: prioritize recent, repeated and higher-severity deficiencies instead of relying only on the count.
3. Check staffing: compare nursing hours, RN coverage, weekends and turnover.
4. Review enforcement: note fines, payment denials, abuse indicators and Special Focus status.
5. Check practical fit: distance, visiting access, language, dietary needs, transport and specialist coordination matter.

Visit more than one facility

A visit can reveal conditions that lagging datasets cannot. Observe whether residents receive timely help, staff address residents respectfully, call lights are answered, common areas and rooms are clean, and meals and activities match resident needs. Visit at a different time if possible rather than relying on one scheduled tour.

Confirm costs and coverage in writing

Ask for the daily or monthly rate, included services, optional charges, deposit and discharge policies. Medicare coverage for skilled nursing facility care is conditional and is not the same as open-ended long-term custodial care. Medicaid rules and eligibility vary by state. Confirm the person's situation directly with Medicare, the state Medicaid program and the facility.

Official sources and methodology

• Medicare nursing home visit checklist (PDF)
• Medicare Care Compare
• Medicare skilled nursing facility coverage
• NursingHomes.us data sources and update policy