When you visit a nursing home to check it out, coming prepared so you know exactly what to ask, see, and do is critical. You’ll want to conduct at least five separate interviews and tour the buildings and grounds. You can look over U.S. News’s checklist, then click here to download it and print it out to take with you. You can personalize it after downloading by adding and deleting items.
[See America’s Best Nursing Homes and search for one near you.]
Questions for a top administrator or director of nursing:
Problems or special needs:
- How would your home deal with my father’s [dementia, weight loss, disability following stroke, or ____________________ ]?
- How do you handle incontinence?
- How often do staff members help incontinent residents use the restroom?
- Are many in diapers?
- Do you ever use catheters?
- How flexible is your menu—can residents make choices and are all Monday meals the same, for instance?
- How do you identify residents who are losing weight?
- What do you do to make sure residents are eating, especially those who have lost interest in food?
- Can residents eat meals whenever they want, or are meals only at scheduled times?
- Are healthy snacks available?
- Does your home honor religious or cultural dietary restrictions? Could you show me a sample menu of a [gluten-free, dairy-free, Kosher, low salt, or ______________] diet?
- How do you ensure that your meals meet high nutritional standards?
- What do you do to prevent falls?
- How often do residents fall?
- What do you do when there’s a fall?
- Please show me your last three survey inspection reports.
- How has your home fixed any problems that were identified?
- How quickly were the problems addressed?
- How often is a doctor on site?
- Are dental services available?
- How do you keep track of residents’ medical records?
- If you have computerized health records, have you ever had any problems with the system?
- Do residents receive preventive care such as annual flu and pneumonia shots?
- Does your home arrange for regular hearing or vision screening?
- If Mom has a medical need, who contacts the doctor?
- If Mom needs to see her doctor, who arranges for transportation?
- What hospital arrangements do you have for emergencies?
- What is annual rate of your nurse and nurse aide turnover?
- What do you do to try to improve turnover?
- How often do you use agency temp nurses?
- What proportion of families would you say hire private nurses to supplement your staff nurses?
- How often do nurses update doctors on residents’ health status?
- What kinds of background checks do you perform prior to hiring?
- Do you have volunteer programs?
- Do you have a relationship with local schools or houses of worship?
Worrisome or missing data
- I would like to discuss a few problems I’ve found out about such as [a high percentage of residents with moderate to severe pain; NA entries; etc.].
- Do you have an emergency evacuation plan?
- Do you hold regular fire drills?
- Who helps residents with bathing?
- Do you do nightly bed checks?
- How often does the staff check on residents during the day?
- What improvements have you put in place in the past year?
- What other improvements are planned?
- Do you often have to put residents on a waiting list?
- Where would we direct our questions and concerns if we were to enroll our dad here?
Questions for the nursing staff:
- How many residents do you care for?
- Is that too many or about right?
- About how much time do you try to spend with each resident?
- Do you like working with older people?
- Is this a good place to work?
- Do you get training and continuing education?
- What do you get if you take part?
Questions for residents:
Quality of life
- Do you have friends here?
- Are you as busy as you want to be?
- Does the home arrange outside activities for you?
- Can friends and family visit whenever they want?
- Do you get to suggest or plan activities?
- Do your visitors ever bring pets with them?
- Do you like the nurses and aides?
- Do you have the same ones most of the time or do they change a lot?
- Do they help you to the bathroom, and if you need help, do you get it in time?
- Do you ever need help eating?
- If so, do you always get help without waiting too long?
- Are you often thirsty?
- Do you have a special diet? (If yes:) Do you like the diet choices?
Questions for other families:
- What are your loved one’s medical concerns?
- Does she get enough of the right kind of care?
- Has she ever had a fall here? (If so:) What happened, and were you satisfied with how it was handled?
- How confident are you that it won’t happen again?
- Does he receive the help he needs to go to the restroom?
- Have you ever come to visit and found him sitting in his own waste?
- Does your loved one need assistance eating?
- Does he get help? Does he have a good appetite?
- If not, does the nursing home do anything to help stimulate his interest in food?
- How well do you think the staff here manages your loved one’s prescriptions?
- Have there been medication-related problems?
- If he is drowsy, confused, or inattentive, do you believe he may be receiving too many drugs or the wrong ones—or too much of one or more drugs?
Quality of life
- Does your loved one participate in activities?
- Are there options beyond bingo and movies?
- Are there activities suited for different levels of cognitivity?
- Do residents take excursions outside the home?
- Is your loved one dressed in her own clothes when you visit, or is she wearing a hospital gown?
- Was your mom able to bring personal belongings, such as pictures or furniture, with her when she entered the home?
- Is there enough storage space, such as closets?
- Can you help me understand some aspects of the ratings or the health inspections that aren’t clear? How significant is __________ violation? How would you evaluate the way the home handled the problem?
- Do you think this home will be able to meet my dad’s needs?
- Is there anything you know about this nursing home that you think would help me make my decision?
Questions you can answer on your own:
- Is the parking lot full?
- Are grandchildren or family and friends around?
- Are there lots of activities available?
- Is the facility creative, regularly offering outings to museums or baseball games, art classes, or gardening on the grounds?
- Do volunteer musicians and other entertainers visit regularly?
- Do children or young adults from classrooms or youth groups come to do crafts, perform, or participate in other activities with residents?
- Is there a beauty salon or barbershop?
Quality of life
- Are residents dressed in hospital gowns or their own clothes?