How to Get Someone Into a Nursing Home: Step-by-Step Guide

Whether the decision is sudden (following a hospitalization) or planned in advance, getting a loved one into a nursing home involves navigating multiple systems simultaneously — medical, financial, and administrative. This guide walks you through every step.

Step 1: Get a Medical Assessment

Nursing home admission requires a physician to certify that the patient needs nursing-facility-level care. This assessment typically happens in one of two ways:

• After a hospital stay: The hospital’s discharge planner or social worker initiates the process. They will assess care needs and help identify appropriate facilities. This is the most common pathway for Medicare-covered SNF admissions.
• From home or assisted living: The patient’s primary care physician can order a nursing facility assessment and complete the necessary paperwork for elective admission.

Step 2: Identify the Type of Care Needed

Clarify whether your loved one needs:

• Short-term rehabilitation (physical therapy, occupational therapy, skilled nursing) — typically covered by Medicare for up to 100 days after a qualifying hospital stay
• Long-term skilled nursing care — for chronic medical conditions requiring ongoing nursing supervision
• Long-term custodial care — for those who need help with daily activities but have exhausted Medicare SNF benefits

The type of care needed determines what you pay, what Medicare or Medicaid covers, and which facilities are appropriate. See our complete nursing home guide →

Step 3: Research and Choose a Facility

Use Medicare Care Compare to search for Medicare-certified nursing homes near you. Filter by star rating (aim for 4–5 stars) and review the most recent inspection report.

If time allows, visit your top 2–3 choices in person. If admission is urgent (same-day or next-day from a hospital discharge), your hospital social worker will contact facilities to check bed availability. Use our nursing home checklist → for guided questions.

Step 4: Verify Insurance and Financial Coverage

Before admission, confirm:

• The facility accepts Medicare or Medicaid (if applicable)
• The patient had a qualifying 3-day hospital inpatient stay (for Medicare SNF coverage)
• Whether a Medicaid application needs to be initiated
• The daily or monthly private-pay rate if coverage is limited

Step 5: Complete Admission Paperwork

You’ll be asked to sign several documents at admission. Read carefully before signing:

• Admission agreement: The contract governing the care relationship — review billing, discharge policies, and what’s included vs. extra charges
• Financial responsibility: Nursing homes cannot require a third party (family member) to sign as a personal guarantor — this is a common illegal practice. Only the resident or their legal representative (power of attorney) should sign financial documents.
• Advance directives: DNR orders, POLST forms, healthcare proxy — ensure these reflect the resident’s wishes
• HIPAA and privacy forms: Designate who can receive health information

Step 6: Move In and Get Oriented

On move-in day:

• Bring personal items that provide comfort and familiarity (photos, a favorite blanket, books)
• Label all clothing and personal belongings
• Meet the nursing staff and ask about care routines
• Ask when the first care plan meeting will be held (required within 14 days of admission)
• Get the name of the patient’s assigned social worker and nursing supervisor

After Admission: Staying Engaged

Research consistently shows that residents whose family visits frequently receive better care. Participate actively:

• Attend all care plan meetings (required at least quarterly)
• Review the monthly bill carefully and question any unfamiliar charges
• Join the Resident and Family Council if available
• Know your loved one’s rights — contact the Long-Term Care Ombudsman for any unresolved concerns

Missouri’s Long-Term Care Ombudsman program: (800) 309-3282