Choosing a nursing home is too important to leave to gut instinct alone. Use this checklist during your facility tours to systematically evaluate every option — and avoid costly mistakes.
Before You Visit: Research Checklist
- ☐ Look up the facility on Medicare Care Compare — note overall, staffing, and health inspection stars
- ☐ Download the most recent health inspection report — review deficiency citations
- ☐ Check for any Special Focus Facility designation (indicates serious ongoing problems)
- ☐ Look up the ownership history — frequent ownership changes can indicate instability
- ☐ Ask for the most recent Staffing Report (available on Care Compare)
During Your Tour: What to Observe
Environment
- ☐ Does the facility smell clean? (Persistent odors signal inadequate staffing)
- ☐ Are common areas clean and well-maintained?
- ☐ Are resident rooms personalized and comfortable?
- ☐ Is there outdoor space for residents and visitors?
- ☐ Are hallways unobstructed and well-lit?
Staff Interactions
- ☐ Do staff greet residents by name?
- ☐ Are staff attentive and unhurried?
- ☐ Do residents look comfortable and cared for?
- ☐ Are call lights answered promptly?
- ☐ Is there visible activity in common areas during your visit?
Meals and Nutrition
- ☐ Ask to see a weekly menu — is there variety and choice?
- ☐ Can residents eat in their rooms if preferred?
- ☐ How does the facility accommodate special diets (diabetic, low-sodium, pureed)?
- ☐ Are snacks available between meals?
Questions to Ask Administration
Staffing
- ☐ What is the RN-to-resident ratio on day, evening, and night shifts?
- ☐ Is there a registered nurse on-site 24 hours a day (not just on-call)?
- ☐ What is the annual staff turnover rate?
- ☐ Do you use “consistent assignment” (same aides for same residents)?
- ☐ What is your policy for filling shifts when staff call out?
Care and Medical
- ☐ Who is the facility’s medical director, and how often do attending physicians visit?
- ☐ What is your hospitalization rate? (Lower is generally better — indicates issues are managed on-site)
- ☐ How do you handle falls prevention?
- ☐ What is your pressure injury (bedsore) rate?
- ☐ How are care plans developed and updated?
Family Communication
- ☐ How will you notify family of health changes or incidents?
- ☐ Can family members attend care plan meetings?
- ☐ What is the process for raising concerns?
- ☐ Is there an active family council?
Financial and Administrative
- ☐ What is the daily rate for Medicare, Medicaid, and private pay?
- ☐ What services are included vs. billed separately?
- ☐ What is the process if a Medicaid application is pending?
- ☐ What are the discharge policies?
Questions to Ask Residents (If Possible)
- ☐ Do you feel safe here?
- ☐ Are the staff kind to you?
- ☐ Do you get enough to eat?
- ☐ Is there enough to do here?
- ☐ Would you recommend this facility to a friend?
Tip: If administration is reluctant to let you talk to residents or seems guarded during your visit, that itself is a red flag.
Want Someone to Do This Research for You?
A Place for Mom’s advisors have already toured facilities in Jefferson County and the St. Louis area and can match your loved one’s specific needs — free to families.
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