Shopping for the right nursing home

nursing home

Finding a nursing home where she will be happy takes leg work. But isn't it worth the effort? Image: luuns/Flickr/CC BY-ND

Too often the elderly are treated as something to manage, rather than as the respected delegates of a previous generation. Care for the elderly has become increasingly costly and, according to some, is not meeting the legal federal standards imposed more than two decades ago. Choosing the right nursing facility is not a task to be taken casually. Here are some pointers on how to shop for the right home for your elderly loved one.

Nursing Home Reform Act

In 1987, Congress enacted the Nursing Home Reform Act, requiring nursing homes to provide a high level of care in order to qualify for Medicare and Medicaid patients. However, according to Trudy Lieberman of Consumer Reports, most states are not enforcing the act properly because of pressure from the nursing home industry. It is a practice, she says, that occurs across the nation.

A four-step process

Medicare, in its pamphlet “Your Guide to Choosing a Nursing Home,” recommends a four-step process: (1) Find out about nursing homes in your area, (2) Compare the quality of the nursing homes you are choosing, (3) Visit the nursing home and (4) Choose the home that best suits your needs.

(1) Finding out

Medicare suggest beginning with personal recommendations from friends, family, medical professionals and other trusted people. Then you may wish to check the Eldercare Locator at, which lists and rates facilities by locality. Medicare offers a similar service with its Nursing Home Compare at

Consumer Reports has also just released its fifth Nursing Home Quality Monitor list of the 10 best and the 10 worst nursing homes in each state. Each listing had to excel or completely fail in at least one of the “quality indicators” during more than one inspection to be included on the respective lists.

(2) Compare quality

Medicare’s Nursing Home Compare is a good place to go for this as well. It rates the quality of nursing homes via its “five star” rating system.

But don’t rely totally on the Medicare rating, says Jocelyn Montgomery of the California Association of Health Facilities. She says you need to dig a little deeper on the site. Be sure to click on “staffing” and “health inspections” for a more detailed survey of the facility. See if the facility has been cited, what for, and how many times. Finally, click on the “state survey agency” tab for contact information for the local long-term care ombudsman. Give that official a call, too.

(3) Visit the facility

No mater what the rating, this step is essential. And visit more than once. After an initial, official visit, stop by again, unannounced. Ask questions. Does the facility have a unit dealing with any special needs your loved one might have? How much say do residents have in their own care? Are residents assigned to the same staff members, or do they get whoever is available? There are no stupid questions, and you can never ask too many.

(4) Choose the right facility

Once you have made a full exploration of the options available in your community, an informed decision can be made. You and your loved one know best what is important for your situation.

Cost is a factor

Unfortunately, many elderly home owners will sign over their long-time residences in order to pay for long term care. The median price of a nursing home nationwide is nearly $200 a day.

Don’t rely on Medicare; it will only cover a stay of 100 days following a hospitalization. Most long-term health care insurance policies also have an “elimination period” of 60 to 90 days before they will start to pay, so dovetailing it to kick in after Medicare runs dry is a good plan, if possible. When resources run low, or if the resident has few assets to begin with, Medicaid may be able to help.

[Short-term loans for when life hands you the unexpected]

Waiting lists

Another factor to consider is that many quality nursing homes have long waiting lists for new residents. If you know mom or dad may be needing one in the relatively near future, and you have your heart set on a certain facility, it would be wise to get on that list now.




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