Questions to Ask a Nursing Home
For a son, daughter or spouse choosing a nursing home for a relative, on a tour or an admissions call. The questions follow the order the decision usually takes: what to settle before the tour, then staffing, medical and dementia care, safety, daily life, and family contact and what happens when needs change. The notes say what a good or a worrying answer sounds like, and where the rules change from one country or state to the next they tell you to ask what applies locally.
The questions
Each question, and why to ask it
Before the tour
Do you have a bed open now, and if not, how does the waiting list work?
Why ask it
Ask this by phone before you book a tour, because nothing else on the list matters at a home with no place. If there is a list, find out how long people usually wait, whether joining it costs anything, and whether you can turn down an offer without losing your spot. When a hospital is pressing for a discharge date, put the question to three or four homes the same morning.
What kinds of care do you provide: short rehab stays, long-term nursing care, memory care?
Why ask it
The names for levels of care change from one country and state to the next, so describe your relative in plain terms: what they need help with, what the diagnoses are, how the nights go. Then ask which unit they would live on and tour that one. A building that mostly turns over short rehab stays feels different from one where people live for years.
What would make you say you cannot meet someone's needs?
Why ask it
Common limits are tube feeding, oxygen, dialysis, a resident who needs bariatric equipment or one who lashes out at staff. A home that names its limits is easier to believe than one that says it takes everybody. Describe your relative's hardest day and ask whether they have cared for someone like that recently.
Do you accept the program or insurance we will be paying with, and is a bed under it free now?
Why ask it
How nursing home care is paid for depends on where you live, so name the program or the policy: in the US that usually means Medicare, Medicaid, long-term care insurance or the family's own money. A home can accept a program and still set aside only some of its beds for it, which is why the second half of the question matters.
Where can I read your latest inspection report, and what did the inspectors find?
Why ask it
Inspection reports are public in many places, so ask which body inspects the home and where the report is posted; in the US, Medicare's Care Compare site carries them, along with fines and complaint investigations. A straight answer names the findings and says what was changed afterward. Then read the last three years yourself: one poor inspection followed by clean ones tells a different story from the same problem turning up every time.
What does a month here cost, and what is billed on top of that?
Why ask it
One figure for the room and the care, and a printed list of the extras, is enough at this stage: you are finding out whether the home is within reach before you spend an afternoon there. Ask whether the rate goes up as someone needs more help. Deposits, the admission agreement and what happens if savings run out deserve a sitting of their own with the business office.
Who owns and runs the home, and how long have the administrator and the director of nursing been here?
Why ask it
Ownership can be a chain, a charity, a local family or an investment company, and a recent sale often brings new managers and new policies. Two leaders who have each been in the job for several years are a steadying sign. If either post has changed hands more than once lately, ask why, and ask an aide the same thing later.
How do you assess someone before offering a place, and who does it?
Why ask it
You are hoping to hear that a nurse reads the hospital records or meets your relative, and that the home wants the medication list and the daily routine from you. An offer made on the strength of a name and a payment source means nobody has checked whether the care fits. Ask what the assessment would change: the unit, the room, the equipment.
May we drop in again without calling first, at supper or on a Sunday?
Why ask it
A booked tour shows the home at its best hour, with the managers in the building; supper on a weekday or a Sunday afternoon shows how it runs when they have gone home. A warm 'any time' is what you want, and reluctance tells you something the tour will not.
Staffing
On the unit my relative would live on, how many residents does one aide have by day, in the evening and overnight?
Why ask it
Get three numbers, one for each shift, and make sure they count the aides giving hands-on care and nobody else. An average for the whole building hides the night, which is usually the thinnest. Minimum staffing rules vary by place, so ask what the rule is here and how the home compares with it, then put the same question to every home you visit.
Is a registered nurse in the building around the clock?
Why ask it
Requirements differ from place to place, so the useful detail is who the most senior clinician is at three in the morning and how they reach a nurse or doctor above them. If the answer is 'on call', ask how long a call back takes and how far away that person lives.
How much of the care is done by agency or temporary staff?
Why ask it
Agency workers can be skilled, but they arrive not knowing who needs drinks thickened or who gets frightened at bath time. A rough share that is falling is a reasonable answer; if nobody can put a figure on it, watch on the tour whether staff greet residents by name.
How long have most of your aides worked here, and how many left in the past year?
Why ask it
Turnover is something a well-run home knows about itself, and long-serving aides are the people who will know your relative best. Follow with why people leave and what the home has done about it. In the US, Medicare's comparison site lists staff turnover for each home, so you can check the figure you were given.
Are aides assigned to the same residents, or does everyone rotate through the building?
Why ask it
The aide who knows that someone always finishes breakfast is the one who notices the morning they do not, which is the case for steady assignments. Where staff rotate, ask how a new face learns each person's habits before walking into the room.
How many aides and nurses were on this unit last Saturday afternoon?
Why ask it
Asking about one real shift gets a truer answer than asking whether weekends are covered. Therapists, activity staff and managers are often off on weekends; what matters is whether hands-on care thins out too. Some homes post the day's staffing near the entrance, so look for the sheet as you walk in.
How many shifts does a new aide shadow someone before working alone, and is dementia part of the training?
Why ask it
A number is the first thing to get, then the subjects by name: moving people safely, infection control, swallowing, dementia, spotting and reporting abuse. Ask whether night staff, cleaners and kitchen workers get the dementia part too, since they meet residents in the corridor like everyone else. 'They are all certified' answers a different question.
Care and dementia
Who would be my relative's doctor, and how often are they in the building?
Why ask it
Some homes have a physician or nurse practitioner on site on set days, and others depend on outside doctors who visit when they can. Ask whether the current doctor may carry on, how a resident asks to be seen, and who the nurses call after hours. A vague 'the doctor comes regularly' should be turned into days of the week.
How are medications given and checked, and who reviews the whole list?
Why ask it
You are listening for a process: who gives each round, how a missed or wrong dose is recorded, and how often a pharmacist or doctor looks at everything together. Ask what happens to the list when someone comes back from the hospital with new prescriptions. Mistakes happen in every home; what you are checking is that this one writes them down and looks for the pattern.
How is pain noticed and treated, especially in someone who cannot describe it?
Why ask it
Staff who are good at this watch for changes they can name: a grimace when turned, an arm held still, eating less, sudden irritability in someone usually mild. Ask who an aide reports that to and how soon a nurse comes to look. If your relative has a long-standing pain problem, describe what works at home and ask how it would be kept going here.
What therapy do you have on site, and how many days a week?
Why ask it
Physical, occupational and speech therapy may be the home's own staff or a contractor who comes in, and weekend sessions are not a given. Walk past the therapy room and see whether anyone is in it. Then ask what keeps a resident walking once formal sessions end, and whose job that is.
If the plan is to go home after rehab, when does planning for that start, and who runs it?
Why ask it
For a short stay this matters as much as the therapy. A home used to sending people home starts in the first days, with a goal you can picture, such as climbing the six steps to the front door, a named social worker or discharge planner, and someone who teaches the family the transfers and the medications. How many days are paid for depends on your coverage, so put that question to the home and to the insurer separately.
How do you prevent pressure sores, and how many residents have one at the moment?
Why ask it
A home that tracks skin problems knows its number without looking it up. Listen for a routine: regular turning for people who cannot shift themselves, skin checks at bath time, special mattresses when they are needed. If your relative spends most of the day in bed or a chair, ask what their own schedule would be.
How often are residents helped to the bathroom, and what happens at night?
Why ask it
The answer you are after is help on a schedule that suits the person; 'they press the bell when they need us' leaves a lot to the call button. Ask whether someone who can still use the toilet with help is ever put in briefs to save time. The air on the unit in mid-afternoon will tell you part of this without a word.
How often is a bath or shower offered, and can residents choose the time and the aide?
Why ask it
Ask for the number per week and what happens when someone says no on the day. Morning or evening, bath or shower, and a man or a woman helping are all reasonable things to choose. For a person with dementia who fights the shower, ask what staff try before giving up or insisting.
Do a dentist, an eye doctor, a podiatrist and a hearing specialist visit, or do families arrange that?
Why ask it
Teeth, feet, glasses and hearing aids are the care that tends to lapse first after a move. Find out who visits and how often, who takes a resident to an outside appointment, and whether an escort is charged for. Ask as well who puts in the hearing aids and cleans the glasses each morning, a small job that decides whether they get worn.
If a resident becomes ill at night, who decides whether they go to the hospital?
Why ask it
Some homes can do a good deal on site, such as fluids, blood tests or a visiting x-ray service, and others send most people to the emergency room. Find out which kind this is, who makes the decision at that hour, and how a resident's wish to stay put is recorded so the night nurse can find it.
Is there a separate memory care unit, and how do you decide who lives there?
Why ask it
A secured unit can mean specialist care or just a locked door, so ask what is different about it: staff numbers, training, the layout, what residents do all day. Find out as well who decides that someone should move onto the unit or off it, and how much say the family has.
How do you respond when a resident with dementia is distressed, refuses care or lashes out?
Why ask it
Skilled staff start by looking for the cause: pain, hunger, noise, a full bladder, a rushed approach. An answer that goes straight to medication, or to calling the family to come and calm them, deserves more questions. Ask how many residents are given calming drugs for behavior and who has to agree before one is started.
How do you help someone who keeps asking to go home or looking for a person who has died?
Why ask it
This comes up daily in dementia care, so experienced staff have an approach and can describe it. Listen for kindness and for something practical, like walking with the person, talking about the home they miss, or offering a job to do. Put the same question to an aide on the unit; theirs is the answer your relative will actually get.
Safety
What do you do to prevent falls, and what happens after one?
Why ask it
No home can stop every fall, and one that promises to may be doing it by keeping people in chairs. Good signs are an assessment on arrival, help offered at the risky moments such as getting to the bathroom at night, and a look at shoes, lighting and medication. After a fall, ask who examines the resident, how soon the family hears, and what gets changed.
Do you use bed rails, lap belts, chair alarms or sedating medicine to keep residents from getting up?
Why ask it
What counts as a restraint, and who has to consent to one, differs from place to place, so ask for this home's rule. A thoughtful answer talks about alternatives: a low bed, a mat on the floor, more company, working out why the person keeps trying to stand. A row of residents asleep in chairs at eleven in the morning is a reason to ask again.
When a resident presses the call button, how long do they usually wait, and do you keep track?
Why ask it
On the tour, notice any lights lit above doors and time how long one stays on: that is the home's answer whatever you are told. If the system keeps a record, ask to see last week's. Ask separately about the hour after supper and the middle of the night, when fewer people are on.
How are residents who cannot stand moved, and do you have enough lifts?
Why ask it
Look for mechanical lifts on the unit itself, not in a closet on another floor, and ask whether two staff are always present to work one. Where aides lift people under the arms because the lift is busy or broken, both the resident and the aide can get hurt. If your relative needs a particular sling or chair, ask whether the home has it or would order it.
How do you stop a resident who wanders from leaving unnoticed?
Why ask it
Door codes, wearable alarms and an enclosed garden are the usual tools. Ask whether anyone has gone missing and what changed afterward; an honest account of a bad day is better than 'that could not happen here'. Check the other side as well: whether a resident who is safe to walk outside can do so without asking permission.
How do you protect residents from rough handling, theft or abuse, and what happens when someone reports it?
Why ask it
An administrator who has thought about this answers without taking offense. You want to hear what background checks are run on staff, agency workers and volunteers, who outside the home must be told (the duty differs by place, so ask), and whether an accused worker is kept away from residents while it is looked into. Ask too whether each room has a drawer that locks.
What do you do when one resident frightens or hurts another?
Why ask it
On a dementia unit this is a familiar problem, so expect a practiced answer: who gets moved, how both families are told, and what staff do to see it coming, such as seating two people apart at meals. If your relative would share a room, press for an example.
What did you do the last time flu, a stomach bug or COVID went through the building?
Why ask it
A story about a real outbreak shows more than an infection policy does: how quickly families were told, whether sick residents were cared for in their rooms, and what happened to visiting. Ask which vaccines are offered to residents and staff, and how consent works.
If there were a fire, a flood or a long power outage, where would residents go and how would we hear?
Why ask it
The detail that matters is where people who cannot walk would be taken if the building had to be emptied, in what vehicles, and when staff last practiced it. Ask how long the backup power lasts and whether it covers oxygen machines and the cooling in summer. Then ask how families would be told, since the home's own phones may be down.
Are families allowed to put a camera in a resident's room?
Why ask it
Whether this is permitted, and whose consent is needed, depends on the law where you live and on the home's own policy, so ask to see the policy in writing. A roommate's privacy is part of it, and so is whether your relative wants to be filmed. An administrator who explains the rules calmly is a better sign than one who bristles at being asked.
Daily life
Can residents get up, eat and go to bed when they like, or does the day run on a set schedule?
Why ask it
Give an example from your relative's life: someone who has slept until nine for forty years, or who has always had a bath before bed. A home built around its residents will tell you how it would fit that in. 'Everyone is up for breakfast at seven' tells you the day is arranged around the staff schedule.
How do you learn what a new resident's life has been and what they like?
Why ask it
Some homes fill in a life history with the family and keep a short version in the room where every aide can read it. Offer to write a page yourself: the name they answer to, their work, what calms them, what they will not eat. Then ask who would read it, because a form filed in the office helps nobody at bath time.
May we stay for a meal and see this week's menu?
Why ask it
Eating there is the best check you have. See how long people wait once they are seated, whether there is a real choice, and whether those who need help eating get it while the plate is still warm. Ask what someone gets if they want neither option, and what is available at nine at night.
How do you manage special diets, swallowing problems and food from our own tradition?
Why ask it
Ask to see a pureed meal as it is served, since care taken over that plate says a lot about the kitchen. For halal, kosher, vegetarian or a regional cuisine, find out whether it is cooked there or brought in, how often, and whether families may bring food from home.
What happens when a resident stops eating well or starts losing weight?
Why ask it
A home that is watching weighs residents on a regular day, has a named person who is told when the number drops, and tries practical things first: someone sitting with the resident, favorite foods, snacks between meals. Ask how soon the family would hear about it. During your visit, watch whether trays are cleared untouched without anyone asking why.
What did residents on this unit do yesterday afternoon, and how many joined in?
Why ask it
The printed calendar shows what was planned, and yesterday shows what happened. Ask about evenings and weekends, and about people who stay in their rooms or cannot follow a group: who visits them one to one, and how often. If your relative has a particular love, gardening or cards or hymns, ask how they would keep it up.
Who notices when a resident seems low or lonely, and what do you do about it?
Why ask it
A move like this is hard on most people, and sadness is easy to miss in someone quiet who gives no trouble. A good answer names who is watching (the aides, the activity staff, a social worker) and what follows: more one-to-one time, a call to the family, a visit from the doctor or a counselor. Ask how a resident gets to see someone trained in mental health, and how long that takes.
How often do residents get outdoors, and can they reach the garden on their own?
Why ask it
A pretty courtyard behind a locked door gets less use than a plain one that residents can walk into. Ask who takes out the people who need a wheelchair pushed, and what happens in winter. Outings count too: where the last one went, and whether a resident who needs a lot of help was on it.
Would my relative have a private room or a shared one, and how are roommates matched?
Why ask it
See the room on offer, not the one kept for tours, and check where the bathroom is and how many people share it. For a shared room, ask what is considered when pairing people, such as sleep habits, television, hearing and confusion, and how quickly a move happens when two people do not get along.
What can we bring from home: furniture, pictures, a television, a pet?
Why ask it
For someone whose memory is failing, the chair they have sat in for years and the photographs they know can be what marks the room as theirs. Ask what is refused and why (rugs and extension cords often are, for safety) and how much fits beside the bed in a shared room. If an animal matters to your relative, ask whether pets may live in or only visit.
How is laundry done, and how often do clothes go missing?
Why ask it
Every home loses some clothing, so the candid answer is 'sometimes', followed by how items are labeled and where the lost and found is kept. Ask whether you may take laundry home if you prefer. Get the policy on lost glasses, hearing aids and dentures as well, including who pays to replace them.
How do you support a resident's faith, language and customs?
Why ask it
Ask what happens on site, whether anyone can be taken to their own place of worship, and which clergy visit. If your relative is most at ease in another language, find out who on each shift speaks it, since an interpreter by phone is little help at bedtime. Mention any customs around food, modesty or prayer now, and notice whether the reply is specific.
Family and changes
When can family visit, and is anything off limits?
Why ask it
Hope to hear that family can come at any reasonable hour. Visiting rights are partly a matter of law, which varies, so ask what residents are entitled to here. Check the edges: mealtimes, late evenings, children, dogs, staying overnight when someone is very ill, and whether there is somewhere quiet to sit other than the bedroom.
If my relative falls, becomes ill or has a medication changed, who tells us, and how soon?
Why ask it
You want a role and a time frame, such as the unit nurse the same day, and an example of a call made last week. Agree within the family who the one contact will be, and ask how the home records what the resident wants shared and with whom, since privacy rules vary. Say whether you want to be woken for news at night.
How can we reach our relative directly: a phone in the room, internet, video calls?
Why ask it
Ask what is provided and what you would have to set up. For someone who cannot manage a phone or tablet alone, the real question is who will help and whether that can happen at a set time each week. Relatives who live far away should ask this one themselves.
How soon after moving in is the care plan written, and is the family in the room?
Why ask it
When the first plan is due and who has to be at the meeting differ from one place to another, so ask for this home's practice and how often the plan is reviewed. The reply you want includes your relative having a say, an invitation for you, and a way to join by phone if you cannot travel. Ask who checks that what was agreed is happening on the night shift.
What do the first two weeks look like for a new resident, and how can we help?
Why ask it
A home with a settled routine can describe it: who greets the person, who eats with them the first day, when a nurse reviews how it is going. Ask what they have seen help, since opinions differ on whether to visit daily at first or leave some space. Request a call from a named person at the end of week one.
Can you tell me about a complaint a family made recently and what came of it?
Why ask it
A real example, with a named person, a time frame and a change that followed, shows whether complaints are heard or managed. Ask which outside body takes complaints about nursing homes where you live, an ombudsman or the regulator, and where its number is posted in the building.
Is there a residents' or family council, and what has changed because of it?
Why ask it
A council that meets and can point to a result, a later supper or a new shower schedule, shows that residents are listened to. Ask whether you could speak to a family member who sits on it. Visitors in the lobby and the parking lot will also tell you things no brochure does, if you ask them how they find the place.
If my relative's needs increase, can they stay here, and in the same room?
Why ask it
You asked at the start what the home cannot take on; this is the same question a few years in. Find out whether more care would mean another unit, another room and a new set of aides, since those relationships are much of what makes a place feel safe, and whether the rate would change. If some residents do have to move on, ask where they usually go and who helps arrange it.
For what reasons would you ask a resident to leave, and how much notice would we have?
Why ask it
The grounds for discharge and the right to appeal are set by local law, so ask what applies here and read the same section of the agreement. Then ask how many residents were asked to leave last year and where they went. Hesitation about behavior linked to dementia is worth probing if that is your relative's diagnosis.
When a resident goes to the hospital, what do you send with them, and do they come back to the same room?
Why ask it
A careful handover includes the medication list, the person's usual state of mind and mobility, any wishes about treatment and a phone number for the family. Ask who from the home checks on them while they are away. Whether the room is kept, and for how long, is a point to settle with the business office before admission.
Can you care for someone through the end of life, and do you work with a hospice?
Why ask it
Many families hope to avoid one more move in the last weeks. Ask which hospice or palliative teams come into the building, whether relatives can stay overnight, and where wishes about resuscitation and hospital transfers are kept so that night staff can find them. Which documents record those wishes depends on where you live; ask what this home uses.
What is the home trying to improve this year?
Why ask it
Every home has something, whether it is night staffing, complaints about the food or how long call lights stay on. An administrator who names it and says what is being done is one who looks at the place critically. 'Nothing, we are very proud of our care' is the less reassuring reply.
How to tour and compare nursing homes
Practical guidance for the conversation itself
Before you visit
Send a one-page picture of your relative
List what your relative needs help with: walking, the bathroom, eating, memory, nights, medication. Send it to the admissions office ahead of the tour. The answers you get will then be about this person, and a home that cannot manage them can say so before you drive over.
Read the public record first
Find out which body inspects nursing homes where you live and read the latest report for each home on your list. Note two or three findings and ask about them in person. How a manager talks about a bad finding is as useful as the finding.
Rule homes out by phone first
Whether a bed is open, whether the home takes the way you will pay, and whether it can care for someone with your relative's needs are yes-or-no matters. Most of the Before the tour group works on a call, and a home that fails one of the three comes off the list without a drive. Keep the visit for what you have to see and hear.
Go in pairs, and bring your relative if you can
One person asks and the other watches and writes. If your relative is able to come, even for half an hour, notice how staff speak to them: to their face and by name, or over their head to you.
On the tour
Read the small signs of care
Clean nails, combed hair, glasses on and wiped, a drink within reach of the person in bed: these are the work of an aide who had time. Notice the smell on the unit too, and be as curious about heavy air freshener as about anything worse. The lobby furniture tells you only what was spent on the lobby.
Ask an aide what you asked the office
Stop an aide for a minute and ask how long they have worked here and how many residents they have today. Ask what they find hardest about the job. Where the corridor and the office give the same numbers, you can trust the rest of what you were told a little more.
Ask about last week, not about policy
Ask for the last fall on this unit, the last complaint, the last outbreak, the last resident who would not eat: what happened, who was told and what changed. A falls program can be recited by anyone in the office. The particulars of last Tuesday can only come from a home that was paying attention.
Come back at a different hour
The first visit is usually mid-morning on a weekday, when the building is at its fullest. Return at supper or on a Sunday without calling ahead. If the place feels much the same, that tells you more than the first tour did.
Comparing two or three homes
Line up the same numbers
For each home write down residents per aide on each shift, whether a registered nurse is there overnight, the share of agency staff, how many aides left last year and how long the administrator has been in the job. Where a home could not give you a figure, write that down too.
Count the drive honestly
A home fifteen minutes away that you can visit several times a week may serve your relative better than a finer one an hour away. Regular visitors notice a change early and are known to the staff. Work out who in the family will go, on which days, and how long each trip takes.
Check what you heard against what is published
Where staffing, turnover or inspection results are published, compare them with what you were told on the tour. Small differences are normal. A large one is worth a phone call to the administrator before you decide.
When a hospital is setting the deadline
Ask the discharge planner how long you really have and whether a first placement can be changed later; how that works depends on where you live. If there is time to check only two things, make them night staffing and the distance from the people who will visit.
Reasons to keep looking
Figures nobody will give you
A home that will not say how many residents each aide has, or how many staff left last year, either does not know or would prefer you did not. Neither is a good start to years of asking questions there.
Residents lined up and silent
Rows of people in wheelchairs along a corridor, a television nobody is watching, staff walking past without a word. One quiet hour proves little, so look again at another time of day. If it is the same, believe it.
Papers pushed across the desk
A hospital discharge can make the timing truly tight, and a home may fairly say that another family is waiting on the same bed. Being asked to sign an admission agreement you have not read is a different matter. Take the papers home, or have them sent to you, before anyone moves in.
A tour that skips the unit
Privacy is a fair reason not to open a resident's door. It is not a reason to skip the unit your relative would live on, the dining room at mealtime or the shower room. Ask to see them, and notice how the request is received.