How to Choose a Nursing Home

Choosing a Nursing Home

Choosing a nursing home for a family member can be stressful and time-consuming. Fortunately, resources are available to help you find and evaluate skilled nursing facilities. Key factors to consider include the location of the facility, its participation in Medicare and Medi-Cal, its compliance with public standards, and how well its services meet your needs.

1. Consult CANHR’s Nursing Home Guide

California Advocates for Nursing Home Reform (CANHR) provides an online guide with in-depth information on all 1,300-plus nursing homes in California, including interactive searches, comparisons, and details on violations, complaints, staffing, and services. Additional lists of nursing homes by county are available at CANHR’s main website.

2. Consider Medicare and Medi-Cal

In order for Medicare or Medi-Cal to help pay for nursing home care, a facility must be certified by one of those programs. Most California nursing homes participate in both Medicare and Medi-Cal. Because of the extremely high cost of nursing home care—over $7,000 per month, on average—many people need to apply for Medi-Cal once their own funds are depleted. CANHR’s website provides extensive information on Medi-Cal eligibility for nursing home care. Even if your loved one doesn’t need or qualify for Medi-Cal now, it’s best to select a Medi-Cal certified facility in case funds are depleted over time.

Medicare’s short-term skilled nursing facility benefit is very limited, but is often used when skilled nursing care or therapy are needed after hospitalization due to a stroke, surgery, injury, or other medical conditions. When medically necessary, Medicare will pay for up to 100 days of skilled nursing care following a hospital stay of at least three days. In most situations, the medical necessity exists for a much shorter period of time.

3. Make Sure the Facility Is Conveniently Located

Nursing home residents thrive on visits from loved ones. If possible, choose a nursing home that’s close to and convenient for those who will be visiting the most often. When family members and friends are close enough to visit frequently, they can monitor the resident’s condition, participate in care planning, and respond quickly to emergencies.

4. Identify Special Care Needs

Ask detailed questions to make sure the nursing home can meet any special care needs your loved one may have. Specialized respiratory care, for example, is available only at certain facilities. Dementia sufferers may need extra supervision and assistance.

5. Seek References

If possible, learn about facilities from people you trust. Relatives, friends, clergy, local senior groups, ombudsman programs, Alzheimer’s support groups, hospital discharge planners, doctors, and others may have recent experiences with nursing homes in your area. You can also seek opinions from residents and visitors when you visit a facility.

6. Make a Visit

Nothing substitutes for a personal visit to the facility. Be sure to see as much of the facility as you can to get a feel for the quality of care. Pay special attention to how residents are treated by the staff. Residents’ appearance, the use of restraints, the condition of residents’ rooms, and the quality of food and activities can all say a lot about a nursing home. Above all, note the behavior and quantity of nursing home staff. How did the administrator and staff treat you? Remember that you’ll be depending on these people to take care of your loved one.

People sometimes place too much importance on the appearance of a facility. While a nursing home should be safe, clean, and comfortable, an elegant environment won’t do your loved one any good if the facility is too expensive, lacks needed services, or is too far away from family and friends.

To compare different nursing homes, use the Nursing Home Evaluation Checklist.

Arranging Care During Hospitalization

Many people are admitted to nursing homes from hospitals. If your loved one is hospitalized, contact the hospital’s discharge planning or case management department as soon as possible for help arranging nursing home care. Hospital staff will help you secure the care and services your loved one will need upon discharge. For more information on hospital discharge rights, see CANHR’s Fact Sheet on Transfer and Discharge Rights

More Information

It’s a good idea to review CANHR’s Fact Sheet on Nursing Home Admission Agreements before admission to a facility. CANHR also publishes several other useful fact sheets on nursing homes, such as Residents’ Rights and Making Care Plans Work.