What to Look For When Touring a Nursing Home
Questions to Ask When Researching Nursing Homes
Whether you're looking for short-term recovery or long-term care in a nursing home facility, your search carries grave concerns a lot of questions.
Here's a guide to help you find the best care facility when needing skilled nursing assistance. After reading through this information, you'll know what to look for when visiting nursing homes. With the guide, you'll determine the quality of care the facility offers and how it affects your care or your loved ones care more than others.
So before visiting a nursing home facility, be prepared first and know what to look elements to measure. Finding the right service may overwhelm you by the sheer number of questions. Hopefully, you'll have ample time to decide which is the best.
What to Look For When Touring a Nursing Home
Before the visit, make a list of your specific needs and keep them in mind because they have the most relevance when deciding which facility is best for you.
The first impression of a facility happens the first time walking through the door. The front lobby is the most pleasant part of a facility. The people who greet visitors are they happy and friendly, the furniture new, the carpet clean and the walls glean with fresh paint or paper. That's the purpose of a lobby; to appear open, clean, and welcoming.
If you see residents in the lobby area, walk up to them and chat. These few minutes offer you a rare opportunity to get feedback. What to ask the residents:
- How long have they been living in the nursing home?
- How do they feel about it?
- Are they pleased with the care they receive?
- Things they like/dislike?
If you find a family member visiting a relative, ask her what she thinks of the facility and if she's happy with the care the loved one receives?
While you wait for the tour, check out the state inspection report that is hanging on the wall in the lobby. Each state requires the reports be visible to everyone. If you cannot find it, ask where it's hanging. And if you have questions about it, speak up and ask. Pay attention to the violations listed in the report.
You'll be given a tour by either the director of admissions, a director of nursing or a marketing representative. The tour follows a planned and fixed route.
Before proceeding on the tour: sit down with the guide to discuss your background, preferences, needs, or anything at all that you think might be helpful to know. The guide can cater the tour to your interests and needs. Make a list of your priorities.
Ask the guide to show you:
- All the rooms - private, semi, and bedrooms for 3-4 residents
- Dining area
- Joint spaces
- Individual departments
- The grounds
- Activity area
- Fitness room
Questions to Ask about the Nursing Home
- What is the size (number of beds) of the facility?
- What are the care services offered?
- Are multiple levels of care offered?
- Is the home JCAHO accredited (JCAHO is a nonprofit health care accreditation organization)?
- What's the staff to resident ratio?
- What is the restraint policy?
- Who are the visiting physicians?
- Is the nursing home for-profit or not-for-profit?
- Does the home have a religious or fraternal affiliation?
- Request to see the list of Board members.
(Not-for-profit homes have local community leaders on their boards. For-profit homes operate by a corporate board.
Be Observant During the Tour
Be aware of how the people interact and observe if and how the guide engages with the residents.
Things to look for
- Does the staff yell at the residents who have hearing issues?
- Does the facility smell of strong disinfectant or urine? Odors are tale-tell signs that bedding and clothing are not changed promptly.
- Do residents have bedsores that are not treated?
- Are residents groomed? As you pass through the hallway, take note of resident hygiene. Check for details like polished nails, and if the residents have jewelry on.
- Does the facility have a homey feel?
- Are plants, paintings, and lamps placed throughout the community, giving an added feeling of home?
- Do lounges offer a feel of comfort?
- Do the facility offer activities and entertainment?
- Are handrails installed in the hallways for mobility ease?
- Are rooms clearly marked and significant information displayed?
- Are the activities calendar posted and easy to read?
Ask to see a sample of each room type; private, semi-private, and the group rooms. Look at the space in each room and how much room there is between the beds and other furniture.
Is is easy to move around in?
Are the rooms wheelchair accessible?
Have the residents made their space personal by adding more color using a flowery blanket or bedspread? S
Ask what tis he policy on personal belongings? Some homes encourage residents to bring personal belongings while others do not.
Do the rooms encourage privacy? Does a curtain or divider hang between the beds of a semi-private room?
Are the bathrooms shared? If they are, how many residents share the bathroom?
Notice what residents are doing in their rooms, walking around, sitting up, reclining on their beds, or lying in them? Is the resident dressed?
It's better to see residents moving about rather than lying around, unless their taking naps.
Activities, Entertainment, and Recreation
Does the recreation and activities room double for dining too? If so, it suggests limited activities.
What are the activities? Are birthdays celebrated? Are photos from past activities on display? Is the room decorated for seasonal fun?
Speak with the activities director. Ask how she gets residents to participate? Does she actively pursue residents to join in? A sign of a healthy activities director is one that rounds residents up to join in.
Since residents have differing interests, the activity calendar needs to serve a variety of things to do and offer a varied entertainment schedule. They include:
- Mental stimulation
- Religious worship
- Social events
- Creative opportunities
- Smaller group activities
The more fun and activities scheduled, the more you'll enjoy living there.
Types of Therapy
If you or your loved one is there for short-term care and rehab. this is the most relevant part of the tour.
Ask about the staff of the department; qualifications, licenses, physical therapy assistants, or therapist aides and if they're contracted or staffed. Employed therapist offer greater continuity of care for residents. Outside contractors are not consistently serving the residents. Continuity between staff lessens because they out each day.
Watch how the department operates.
Are therapists working with residents one-to-one.
Is the room crowded?
Do therapist have the space to perform treatment?
Is the therapy equipment in good shape?
Is the department equipped for occupational therapy?
Will the therapist go on site to the resident's home and do evaluations before discharge?
Is the dining area equipped to accommodate all residents?
If the dining area is small, ask where the residents eat?
Are some residents spoon fed? Do the dependent residents have opportunities to share meals with others? What happens if a resident misses a meal?
What is the facility's policy on residents eating in their rooms? Residents do have a right to eat in their room, if they choose to.
Meet the dietician and ask if they provide for special diets?
Look at the food menu and glance the food that's served up. Is is appetizing and nutritious?
The outdoor area of the nursing home facility.
You can easily evaluate this part of the facility by simply viewing it, but there are a few specific things to look for.
Is it accessible by wheelchair and walkers?
Do residents easy get around outside?
Are paths and doorways too narrow? .
Are there plenty of sitting areas and places for residents to enjoy the fresh air and have conversation with one another?
Are shaded areas available?
Can residents go outdoors to enjoy fresh air?
Completing the Tour
Once your tour is over, you'll get a chance to ask more questions and speak with the guide. Use this time to get a better feel for the nursing home's philosophy, because the attitude of the staff is ultimately what nursing home quality boils down to.
Ask what makes this nursing home different from others? Does her answer sound generic and full of sales rhetoric?
Does she speak genuinely about the staff and the home?
Does she mention making it home-like,accommodating, and speaks to resident needs rather than company needs?
Does the facility staff appear tight-knit?
If the person you are meeting with has pride and personal investment in the home-which is obviously a wonderful thing for nursing home employees to have-it will come across in this type of conversation.
Family involvement is important for many residents, ask how involved your family can get? Can they get involved in the care plan?
Ask if the nursing home makes any efforts to give their residents control over their own care?How active can residents be how the facility operates; meal planning, gardening, and running of the facility? Do residents get involved in planning activities?
Do they participate in pet therapy? Are residents allowed to bring their pet?
Do they have Intergenerational daycare programs allowing residents to have contact with children?
Speak with staff too, especially the direct care workers like nurses and nurses' aides. They provide the one-on-one care for residents. Are they treated well by the facility administration? What are the staff benefits and educational opportunities?
Hopefully at the end of tour, you walk away with full knowledge of whether the facility is a good fit or not. If you do not, then schedule an appointment to return at a later date to speak with the Director of Nursing or a social worker.
Some return to the nursing home without an appointment. You will have to decide for yourself what will be more helpful and appropriate for your decision-making process.
After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.
- What are Skilled Nursing Facilities?
- Services Offered in Skilled Nursing Facilities
- Compare to Assisted Living
- Myths about Nursing Homes
- Nursing Home Staff
- Nursing Home Administrators
- Nursing Home Costs
- Paying for a Nursing Home
- Medicare and Nursing Homes
- Medicaid and Nursing Homes
- Will Social Security Cover Nursing Home Costs
- How to Find a Nursing Home
- What to Look For When Touring a Nursing Home
- Moving Into a Nursing Home
- Nursing Home Checklist
- Nursing Home Trends
- Nursing Home Technology
- Medicare Quality Data