How do you choose a nursing home that’ll be a good fit for your mother and your family’s peace of mind? This once-in-a-lifetime decision tugs on your heartstrings and challenges your intention to assure her well-being. 

To help navigate this inescapable task, we’ve compiled a checklist of top things to consider before selecting a nursing home for your loved one.

Let’s start with the healthcare industry’s definition of a nursing home to help understand why your mother’s doctor recommended it for her care.

1. What is a Nursing Home?

A nursing home, often called a skilled nursing facility is a care facility for patients who don’t require hospitalization, but need specialized daily care that is best provided in a clinical environment.
 

Nursing homes provide both short-term and long-term care to its residents, depending on their needs: 

• A patient who is recovering from a serious illness or injury may need short-term care and rehabilitation following their hospitalization. Once the patient recovers sufficiently, they’re released to continue their care at home.  
• A patient with an ongoing physical or mental condition who can no longer take care of their own daily needs typically needs the long-term care and assistance that a nursing home can provide. 

Key Point#1: A nursing  home provides a combination of in-house skilled care and custodial care and the majority percentage of the population in nursing homes do benefit from both kinds of care.   

2. Discuss with Family and Friends

Your core family members and friends are your greatest allies in this search, so be sure to solicit their help during this challenging time. Acknowledge that this is a crucial decision with a monumental task, and that Mom’s transition will benefit from their involvement.

However, it’s important to also recognize that they may need some time to feel and process the emotions that reflect the reality that mom will be going to a nursing home. Consider a family meeting to initiate discussion and set goals that’ll meet your mom’s needs.

The direction of the search is a family decision, but respect different perspectives and allow others time to accept your consensus and take time to make note of your family’s various requests.

Naturally, your family members will want to visit your mom periodically. But the reality is that the longer the distance from their home, the less likely they’ll be inclined to take the drive. Determine a mutually preferred area to start your search, increasing the travel radius later if you need to.

Key Point #2: Recognize the emotional impact of this decision and discuss desired outcomes as a family.

3. Understand the Level of Care Needed and Anticipate the Length of Stay in a Nursing Home 

Of course, you want to help select the best care facility that meets your mom’s needs. But, do you fully understand what her needs are?

A complete medical and needs assessment of your mom is a wise first step before deciding on nursing home placement. Results of an assessment by your mom’s physician (or another service) will give you clear guidance on nursing home services that your mom requires and provides your “services requirements list” for your search.

Prior to her admission, the nursing home you select may order a comprehensive geriatric assessment (CGA) to develop her treatment plan. This is a more in-depth assessment which combines findings from her physician and a team of specialists, like audiologists or dieticians. 

With this treatment plan, you should be able to have a better idea of how long of a stay in a nursing home is required. The average long-term stay of seniors in nursing homes is short of about two and a third years, around 835 days. Short-term rehabilitation care in a nursing home averages around 9 months. Knowing this will be important for selecting the right nursing home and making the right budget. 

Key Point #3: Request a geriatric assessment to understand your care requirements of a nursing home for your mom and use it to anticipate the length of time that a loved one will be in residence in nursing home care. Long-term care averages around 835 days and short-term care averages 270 days.

4. Get Organized: Start Your Search and Organize Your Notes

During your nursing home research, which you can start on agechoice.com,  you’ll record notes about each prospective nursing home and share this information with other family members. Minimize any surprises by ensuring that everyone involved stays informed.
 

Choose your preference on note taking, either a dedicated spiral notebook, spreadsheet or your favorite note taking app on your cell phone. Devise a plan for consistently maintaining notes that’ll later become your guide for your selection. Your future organized self will thank you!

To start, create a separate entry (page or tab) for each prospective facility in your area. A web search should provide this basic information:

• Nursing home name
• Website URL
• Physical address
• Distance from family members 
• Phone number

Key Point #4: Once you start your search, which you can begin on agechoice.com, set up an organized method to record your notes which you can share with your family in the selection process. 

5. Your Homework: Start with the Basics

Start diving into the details of your prospects, and record that nursing home information in your notebook.

It‘s helpful to write a “script” of sorts to use when calling for information.  Write down the questions to ask each nursing home. For instance:

• What is your occupancy (How many residents?)
• Is there a choice of private/shared rooms? 
• Is there a waiting list? How long is the list?
• Do you offer the care services that my mother requires?
• Where can I obtain a schedule of fees?
  
  

When you call, enter the administrator’s name and your impressions. Note who you can call for follow-up questions or to make an appointment.

Some facilities on your list of prospects may be at full occupancy or they don’t offer all the necessary services for your mom’s care. If it’s not worth pursuing that facility, focus on the more viable options but retain information already gathered if you need to reconsider. 

Key Point #5:  Develop a consistent script to use when making vacancy and initial data-gathering calls to nursing homes. 

6. Check References 

Now that you have a filtered list of best nursing home prospects, find out what others are saying about your options. Start by reviewing the data provided on public comparison search engines:

• ProPublica, an independent, nonprofit investigative journalism organization, provides data on several public trust concerns, including health care.  Check their Nursing Home Inspect page to search inspection reports on facilities of interest. 
• Medicare offers a free Nursing Home Compare tool which reports several different metrics including number of medicare certified beds, ratings, and number of health and safety violations.

7. On-Site Visits: Observe 3 Key Aspects

When you’ve narrowed your selection to a few facilities, it’s time to schedule your on-site visits.  It helps to be prepared to ask questions and take notes. What to look for in selecting a nursing home can be categorized into three key aspects: 

Administration & Care Staff

Get a feeling for how accessible the administrative staff is and how competently they answer your questions. Remember, the on-site administrative staff will be your primary point of contact when your mom is in residence.

What is the hiring and training process for the care staff? How do they check backgrounds and provide continuing education? What is the staff turnover rate? What procedures do they have to prepare for emergencies?

Observe interactions of the care staff with the residents. Are they respectful and address the residents by name? Note any nursing home red flags, like residents who appear neglected or disheveled.  

The Residents (and Their Family)

Observe a group activity and strike up conversations with residents (and their family, if present). Probing questions about their freedom to choose activities, make their own food selections or determine their own bedtime provide a greater insight into their satisfaction. 

The Physical Facility (Inside and Outside)

Ask yourself if your mom would be comfortable here. Use all of your senses and trust your instincts to gather an impression about the facility. Look beyond deceptive furnishings like crystal chandeliers and truly observe the atmosphere. Are there any unpleasant odors? Is it calm and quiet or noisy and active?

If there are outdoor grounds, consider the surrounding neighborhood, the ability of residents to go outside, and security features to protect them. 

Key Point #7: During site visits, focus on 3 key aspects: administration & care staff, the residents themselves and the physical facility.

8. Financial Considerations

Unfortunately, expenses are an unavoidable part of your nursing home search. Mom’s budget might not cover application fees, transportation and meals during site visits. Understand and agree upon how to manage and fund miscellaneous costs during the search, her transition into residency, and throughout her care.

No doubt, nursing home care is expensive. Prepare for some “sticker shock” when comparing fees. Of course, costs vary by services provided, but 2021 U.S. monthly costs for nursing home care average between $8365 for a private room to $7441 for a semi-private room. On top of that, most health insurance policies do not cover all the costs of care. Most patients cover the costs with a combination of medicare, medicaid and private funds.

An elder law attorney can advise how to get into a nursing home on medicare and help to clarify nursing home contracts, giving you peace of mind about legal commitments. Specializing in the legal needs of older adults, these attorneys can help establish a durable financial power of attorney, which allows a designated person to manage your mom’s finances.   

Key Point #8: U.S. monthly costs for nursing home care average between $8365 for a private room to $7441 for a semi-private room which are usually paid from a combination of medicare, medicaid and private funds.

9. Timing is Important

If you need to find nursing home care for a loved one immediately following a hospital release, a 72-hour time allocation ticks by very quickly and professional assistance is advised. However, if you have the luxury of time to find the right place for mom, your diligence will pay off. Conscientiously, you should visit prospective nursing homes a second or third time without an appointment at different times of the day, especially during mealtimes.    

If time allows before making your final nursing home selection, ask family members to review your notes with you. Your choice may be clear, but be sure to compare mom’s needs with services offered by the facilities you visited, check referrals, and confirm how costs will be covered.

Kety Point #9: You may not have time to decide, sometimes you need to find a nursing home immediately after a hospital release but with whatever time you do have, follow as many steps in this article as possible. 

10. Transition to Life in a Nursing Home

Coordinate your mom’s move to her new community with your family members. Although you may be limited in what you can move in, try to furnish her room with items that'll make her feel at home, like family photos, her trusty radio or favorite rocking chair.

Recognize that there will be a period of emotional and physical adjustment for her and your entire family. Keep the family involved by encouraging frequent visits with mom, accompanying her during dining hall meal times or organized group activities.

Maintain communications with the administrative staff so that changes can be made quickly. With your help and encouragement, mom will make a smooth transition to life in a nursing home that addresses her unique medical and personal care needs.

Key Point #10: Visit your loved one during mealtime or a group activity to encourage involvement and ease the transition into a nursing home.