How to Choose the Right Nursing Home or Retirement Facility

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One of the most difficult decisions in life can be the decision of when and where and with whom to entrust the well-being and care of ourselves or our loved ones  As our population ages, providing care to the elderly is a rapidly growing and expanding industry with a wide array of options and costs and quality. So, when the time comes, what should a family look for in a care facility? Here are the things to think about and look for when deciding on a nursing facility.


Ask around to people who have already gone through the process. Why re-invent the wheel? Don’t forget to ask yours and your loved one’s primary care physician. He or she may have insight gained from other patients.


Being close to family and friends is important to ensure regular visitation, ease of day trips outside the facility, “vacations” with family away from the facility, and access to long-term healthcare providers.  Additionally, residents who receive regular visitors generally receive better care.


Always tour the facility on both scheduled and “surprise” inspections. Don’t be afraid to ask residents about the facility, the staff, the services, and the food.  Here are a few checklists from our friends at MedicareAARP,and a California advocate group.

Quality of Facilities

The primary reason for employing a nursing facility is to keep you or your loved one safe. Check for handrails along the walls, properly placed fire extinguishers, cleanliness of floors and walls, the absence of lingering and unpleasant odors, comfortable temperatures within the facility, locks and working alarms on all external doors, and working fixtures, call buttons and televisions.

Quality of Care

Another reason for paying someone to take care of you or your loved one is to ensure a level of care to keep healthy. Find out how often and what physicians come to the facility and research those physicians. Ask about the licensed nurse to resident ratio within the facility and within the unit, if applicable, as well as the nursing assistant to resident ratio. The lower the numbers, the better staffed the facility.  Under-staffing is an epidemic in nursing facilities and facilities that under staff should be avoided. Remember that it’s the nursing assistants who will be performing the day to day care of your loved one, so in addition to the numbers of staff (which should be greater than 1:20), ask questions about where the facility finds its nursing assistants, what background checks,  competency checks, and training are performed.  Additionally, the Department of Health performs inspections of each facility, found here.

Quality of Services

We all want our loved ones to be happy, so take the time to investigate how the staff interacts with the residents and with you. The initial “gut” feeling that you get about the atmosphere and observations about the condition of the residents and their treatment by staff is usually a pretty good indication of what you can expect.

Quality of Food

For a resident, breakfast, lunch, and dinner, are social focus and highlight of every day.  During your scheduled and surprise tours, sit down and eat. Is it a well-balanced, tasty meal with plenty of choices? Good nutrition is paramount for maintaining physical and mental health and vitality. A menu that you find pleasing will go a long way to keeping you or your loved one in the best overall condition.

Research Complaints

  1. Lawsuits are public records, so take the time and effort to research the number and reasons for lawsuits brought against a facility in the county where it is located. Just because an action is discontinued does not mean that that the lawsuit was “frivolous.” Most healthcare providers require confidentiality, so often the settlements are hidden from the public.
  2. Check the most recent sanctions assessed by the Pennsylvania Department of Health here.  Ask the facility manager to justify the reasons for the sanctions.
  3. Finally, you can also research complaints in the same places available to lodge complaints:
    • The Pennsylvania Department of Health: 800-254-5164
    • Medicare uses a firm called Livanta to handle complaints in Pennsylvania: 866-815-5440.
    • State Board of Examiners of Nursing Home Administrators: 717-783-7155
    • Pennsylvania Department of Aging – Long Term Care Ombudsman: 866-286-3636
    • Joint Commission

Finding the right place to care for an elderly loved one is not only important to your loved one’s health, but to yours, as well. Take the time to research. Finding the right place will minimize the stress and guilt that invariably accompanies this difficult decision, and make your loved one’s transition easier.