Tips on Choosing a Nursing Home

1. Decide what the patient needs: A clear diagnosis from medical providers and social workers can determine whether a nursing home is the best place for the patient or if he needs a home that specializes in a specific kind of treatment or care.
2. Stay close to home: More family visits often translate to more care at a nursing home. The squeaky wheel does get the grease.
3. Check the federal ratings: The Nursing Home Compare Web site -- www.medicare.gov/NHCompare -- is a good place to start your search.
4. Drop in for a visit: If you can, skip an appointment to get a real feel of what day-to-day operations are like. Make sure to meet with an administrator and ask about care planning, specialized services, safety systems, policies and costs.
5. Visit again at a different time: You want to make sure the nursing home is more or less the same during busy meal times and quiet evening hours.
6. Take a bathroom break: Any public restroom gives you a basic idea about a facility's cleanliness, but also check for hot water -- which might be lacking in big homes -- and signs of disrepair.
7. Stop by the kitchen: Make sure the food's tasty, and while you're checking check to see if there's a licensed dietitian on staff and how they handle food allergies and special diet needs.
8. Talk to the staff and residents: Elder care advocates say the best facilities often are the ones that feel the least like a hospital. Notice where residents are, what they're doing and how they look. Are they being cared for in a dignified manner? Is the staff friendly to them and to you? Are people talking?
9. Ask questions: Don't limit yourself to administrators, though they are a great place to start getting information. Talk to residents and sit in on a residents' council meeting. Check on staff turnover rates and training opportunities.
10. Buy yourself some time: If you -- like about half of all nursing home admissions -- are looking for a facility after a hospital stay, you might have just a day to decide which is the best place for you. File an appeal of the hospital discharge to buy yourself an extra two days to check out nursing homes.

Sources: AARP; District of Columbia Long Term Care Ombudsman, NCCNHR (formerly National Citizens' Coalition for Nursing Home Reform), Medicare.