*Disclaimer: Content updated with 3 new questions.
Choosing a nursing home is one of the most difficult decisions a family can make. Whether you’re helping a parent transition into long-term care or preparing for your own future, it’s not just about picking a place, it’s about finding the right level of care, compassion, safety, and dignity.
In this guide, we’ve outlined key questions to ask when touring a nursing home or speaking with its staff. These questions are designed to help you:
- Evaluate the quality of care.
- Understand costs and financial requirements.
- Ensure your loved one’s safety and comfort.
Let’s explore the most important questions to ask a nursing home administrator or care team before making your decision.
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1. What is the staff-to-resident ratio?
A low staff-to-resident ratio can lead to delayed care, overworked staff, and a poor quality of life. Ask how many residents each nurse or aide is responsible for during day, evening, and overnight shifts. Also, ask how this compares to your state’s legal requirements.
A good benchmark is around 1:5 during the day, but ratios can vary based on acuity levels and care needs. Don’t be afraid to ask how the facility adjusts staffing for residents with higher needs, such as memory care or hospice support. Ask how the facility manages staffing on weekends or holidays and whether they rely on temporary or agency staff during shortages.
Why this matters: Better ratios mean more personalized care and faster response times. When staff aren’t stretched too thin, they’re more likely to develop stronger relationships with residents, respond quickly to needs, and prevent accidents or oversights.
2. What is the staff turnover rate?
High staff turnover could mean inconsistent care and communication gaps. Long-term staff tend to provide better care because they understand each resident’s needs over time.
Ask how long the average staff member stays at the facility, especially caregivers, nurses, and aides who interact most closely with residents. Frequent turnover can disrupt continuity of care and may be a sign of poor management or staff dissatisfaction. You may also want to ask how the facility supports its staff, do they provide ongoing training, offer competitive wages, or promote a positive work culture?
Consistent staffing is essential in building trust and rapport between caregivers and residents. When staff stay long-term, they can recognize subtle changes in health or mood, which helps prevent issues from escalating.
Why this matters: Stability often reflects a positive work environment and better resident relationships. A familiar face can be incredibly comforting for residents, especially those with dementia or cognitive impairments.
3. What medical services and specialists are available on site?
Some facilities offer on-site physicians, physical therapy, or memory care specialists. Others may rely on outside providers or referrals.
Ask whether there are registered nurses (RNs) or nurse practitioners (NPs) available 24/7, how often physicians visit, and whether the facility partners with nearby hospitals. Also, inquire if specialists such as cardiologists, podiatrists, or psychologists visit residents regularly.
If your loved one requires specific medical attention (like dialysis, diabetes management, or dementia care), confirm whether staff have the training and tools to provide this care on-site or if they require external referrals.
Why this matters: Access to specialized care ensures your loved one gets the support they need without constant off-site appointments. On-site medical care can reduce hospital trips, streamline treatment, and give families peace of mind.
4. How are care plans created and updated?
Every resident should have an individualized care plan. Ask who is involved in creating the plan (nurses, social workers, physicians) and how often it is reviewed or updated.
Care plans should be updated after any major health event, such as a fall, hospitalization, or change in cognitive or physical status. Ask how often team members meet to review and revise care plans, and whether family members are included in that process. Some facilities hold regular care conferences where family input is welcomed. This is a great opportunity to stay informed and advocate for your loved one’s needs.
You should also find out how residents themselves are involved in their care planning when possible. Their input can help shape daily routines, preferences, and comfort strategies.
Why this matters: A personalized and evolving plan ensures your loved one’s changing needs are always being met. Good care is proactive, not reactive.
5. What is the daily routine like for residents?
Ask about meals, activities, personal care, and free time. Are there structured programs for physical activity or mental stimulation? Can residents choose how they spend their time?
The daily routine plays a big role in residents’ quality of life. Ask whether the schedule is rigid or if residents have flexibility. Are there group activities, like music, art, or games? Can residents participate in religious services, volunteer projects, or social outings? What supports are in place for those with mobility challenges?
Also, ask whether the facility encourages residents to personalize their routines–for instance, waking up and eating meals at times that suit them. A person-centered approach helps residents feel more independent and respected.
Why this matters: A good daily routine should balance safety, independence, and engagement. Residents thrive when they have structure without sacrificing autonomy.
6. How are meals prepared and customized?
Food affects both health and morale. Ask if meals are made fresh, whether menus can be customized, and how dietary restrictions are handled.
Inquire about how often the menu changes and if a dietitian is involved in meal planning. Can residents choose from multiple options each day? Are there snacks available between meals? Ask how the facility accommodates special diets for example, low-sodium, diabetic, gluten-free, or cultural preferences.
Also, consider asking if you can try a meal during your visit. Observe how meals are served–is it buffet-style, cafeteria-style, or restaurant-style service? Are residents encouraged to dine together or in their rooms?
Bonus tip: Try to tour during mealtime and see what’s being served.
Why this matters: Meals are more than nourishment; they’re a daily highlight and a chance to connect with others. High-quality, enjoyable food contributes to better health and emotional well-being.
7. What safety protocols and infection control measures are in place?
Resident safety should be a top priority in any nursing home. Ask how the facility handles emergencies, monitors health risks, and prevents accidents. For infection control, it’s important to understand the steps staff take to reduce the spread of illness, including hand hygiene, cleaning protocols, and how they manage outbreaks like the flu.
Ask whether the facility has dedicated staff for infection prevention and how frequently they update protocols based on CDC or state guidelines. You should also ask about their vaccination policies for both residents and staff.
In addition to infection prevention, explore how the facility handles physical safety: Are hallways and rooms equipped with grab bars and call buttons? Is the building secure? Are exits monitored to prevent wandering among residents with dementia?
Why this matters: Seniors are more vulnerable to infections, accidents, and disorientation. A well-prepared facility can protect your loved one while helping them maintain their health and dignity.
8. How are families involved in care and communication?
Strong communication between the nursing home and families is essential. Ask how the facility keeps families informed about changes in health, care plans, or daily routines. Do they provide regular updates via phone, email, or an online portal? Are family meetings or care conferences scheduled on a recurring basis?
Ask whether families are invited to participate in care planning and decision-making. Can you speak directly with your loved one’s caregivers or assigned nurse? Find out if there are visiting hours or if families are welcome at any time.
Also inquire about social opportunities for families: Are there holiday events, family meals, or activity days where relatives are invited? How does the staff encourage family involvement?
Why this matters: Good communication builds trust and ensures your loved one’s needs are met in partnership with your input. A facility that includes families in care helps residents feel more supported and connected.
9. What are the policies for reporting abuse or neglect?
Your loved one’s safety and well-being depend on the facility’s commitment to preventing and addressing mistreatment. Ask whether the facility has a formal policy for reporting abuse, neglect, or mistreatment, and who residents or family members should speak to if something goes wrong.
Does the facility have a hotline or an anonymous reporting system? How quickly are concerns investigated? Are staff trained regularly to recognize signs of elder abuse or neglect, including emotional, physical, or financial abuse?
Check whether the facility has a history of violations or complaints, which you can often find through Medicare’s Nursing Home Compare or your state’s Department of Health. Ask what disciplinary steps are taken if a staff member is found responsible for inappropriate behavior.
Why this matters: Transparency and a strong accountability process help ensure that your loved one is treated with respect. You should feel confident that any issue will be taken seriously and addressed swiftly
10. What does the fee structure include and what costs extra?
The cost of nursing home care can be substantial, so it’s crucial to get a detailed explanation of what is included in the base monthly rate and what comes at an additional cost. Ask for a printed fee schedule that outlines everything from room and board to personal care services, therapy, and daily activities.
Common services that may incur extra charges include cable TV, Wi-Fi, laundry, personal hygiene supplies, physical therapy, occupational therapy, and transportation to off-site appointments. Some nursing homes also charge extra for private rooms or advanced levels of care.
Also ask:
- Do you accept Medicare, Medicaid, or long-term care insurance?
- What insurance providers are in-network?
- Are there upfront deposits or community fees?
- What happens if the resident runs out of funds or transitions to Medicaid?
If your loved one is applying for Medicaid, ask about the facility’s policies on Medicaid beds and whether there’s a waiting list. For those paying out of pocket, ask about payment options or financial counseling support.
Why this matters: Nursing home costs can exceed $9,000/month. Understanding the full financial picture–including hidden costs–ensures your family can plan effectively and avoid unexpected bills. This conversation can also help you compare facilities more accurately.
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Considering a Nursing Home But Worried About Costs?
Many families are surprised to learn they can use an existing life insurance policy to help cover the cost of care. If your loved one no longer needs their policy, a life settlement could offer a lump sum payment, often more than the cash surrender value.
Curious what your policy might be worth?
Get a free estimate
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11. How to Put Someone Into a Nursing Home?
If you’re trying to place a loved one in a nursing home, you’re not alone and you’re not without help. The process may seem overwhelming at first, but breaking it down into key steps can make it more manageable.
Step 1: Determine Medical Eligibility
A nursing home provides 24/7 care for individuals who have serious health issues or need help with daily activities like bathing, dressing, and eating. A doctor must usually certify that your loved one requires this level of skilled care. If they’re hospitalized, hospital staff will often begin the eligibility assessment.
Step 2: Schedule a State-Level Assessment (if required)
Most states have specific forms or evaluation procedures required for Medicaid-certified nursing homes. This includes a functional needs assessment that measures your loved one’s medical conditions, cognitive abilities, and physical limitations. The state may also require a physician’s order or preadmission screening.
For more details on this process, see this guide on how to get into a nursing home through Medicaid.
Step 3: Prepare the Necessary Documents
You’ll likely need to gather several documents before admission:
- A physician’s order for skilled nursing care.
- Medical history and physical exam.
- Medication and treatment orders.
- Power of attorney (POA) paperwork.
- Advance directives (e.g., DNR, living will).
- Proof of insurance (Medicare, Medicaid, private insurance).
- Social Security and ID documents.
- Financial records, including bank statements and assets.
Tip: Contact the facility in advance to ask for a checklist of requirements.
Step 4: Complete the Financial Assessment
The nursing home will conduct a financial review to determine how your loved one will pay for care. You’ll be asked about:
- Income and benefits (Social Security, pensions, VA benefits)
- Insurance policies (long-term care, life insurance)
- Assets (real estate, savings, trusts)
- Recent asset transfers (Medicaid has a 5-year look-back period)
Families often work with an elder law attorney or Medicaid planner to prepare for this step.
Step 5: Submit Admissions Paperwork and Choose a Facility
Once medical and financial eligibility are confirmed, you can begin the admissions process with a nursing home. You’ll complete the facility’s intake forms, consent documents, and provide all necessary paperwork. Admissions can sometimes be completed within a few days, especially in urgent cases.
Step 6: Consider Emergency Placement Options
If your loved one needs immediate care– for example, due to a caregiver injury or sudden health crisis– ask about emergency or respite admission. In some states, required assessments can be completed after admission in these cases.
Who Can Help?
- Primary care doctor or hospital staff: for assessments and medical documentation
- Area Agency on Aging (AAA): for local referrals and resources
- Elder law attorney:Â for Medicaid planning and legal forms
- Nursing home admissions staff: to guide you through facility-specific steps
Tip: You can find your local AAA (Area Agency on Aging) using the Eldercare Locator.
12. Can I speak with a current resident or family member?
Hearing directly from residents or their families can provide valuable insight into the day-to-day experience at the nursing home–insight that brochures and staff tours simply can’t match. During your visit, ask the administrator if you can speak with one or two current residents and, if possible, their family members. Their perspective can help you better understand the atmosphere, staff responsiveness, and overall quality of life.
You might ask them:
- Are you or your loved one happy living here?
- How long have you been at the facility?
- Do staff treat residents with kindness and respect?
- Are your concerns addressed in a timely manner?
- Do you feel safe and well cared for?
Some facilities also collect and publish satisfaction surveys or conduct resident-family councils. Ask to see recent results or feedback reports. These insights, both positive and negative, can help you make a well-informed decision.
It’s also a good idea to check online reviews and third-party ratings. Resources like Medicare’s Nursing Home Compare, U.S. News & World Report rankings, and Google reviews can highlight trends in quality or red flags that deserve follow-up.
Why this matters: Real-world testimonials are a window into daily life at the facility. They can validate what staff tell you or offer important clues if something isn’t right.
Conclusion
Finding the right nursing home takes time, research, and asking the right questions. Use this list to guide your visits and interviews, and don’t be afraid to take notes or follow up.
Need Help Paying for Care?
If you’re considering a nursing home for yourself or a loved one but are worried about cost, we may be able to help. In some cases, you can sell a life insurance policy through a life settlement and use the proceeds to cover care expenses.
