Nursing Facilities
Visit the Facilities
Use this checklist of questions to help evaluate and compare nursing facilities and to find the best fit for your needs. Some of the answers will be obvious from your observations; others may require you to do some additional digging or consult other people familiar with the facility.
Do not rely on your memory during these visits. Bring a notebook and pen to write down your observations and answers to your questions, as well as the names of people you meet. Not all the questions below will apply to your situation. But the more information you collect, the better you will be able to compare facilities to make the best choice. Don’t be afraid to ask a lot of questions.
Overall Impressions
- Was your first impression a positive one?
- Does it meet your standards for cleanliness?
- Are there unusually strong odors, such as urine or chemical disinfectants?
Bedrooms
- How many residents occupy each room?
- Have residents decorated their rooms with personal belongings?
- What is the facility’s policy on matching roommates?
- Is each individual equipped with: A privacy curtain? A clothes closet or storage area? Fresh drinking water? A call button for assistance? A sturdy, comfortable chair?
Public Areas
- Are the common rooms comfortable, relatively quiet, and adequately lit and ventilated?
- Do residents appear to be using social and activity rooms?
- Is there a quiet place to socialize or have private visits?
Safety
- Is the facility well lit?
- Is the flooring in good condition?
- Are exits and fire exits clearly marked?
- Are there handrails and grab bars in the hallways and bathrooms?
- Are the hallways free of clutter?
Care
- Who puts together the resident’s care plan?
- Are residents and family members or outside caretakers encouraged to participate?
- Is there a plan for emergency medical treatment if needed?
- Can residents receive care from their personal physicians?
Medications
- Can residents store and administer their own medication if they are able?
- If not, who dispenses medications and how is that staff member trained and supervised?
Meals
- Check facilities at various times, but make a special effort to observe during a meal. Ask to see a recent menu plan.
- Are meals nutritious and served hot or cold?
- Do residents seem to be enjoying their food?
- Does the facility consider ethnic food preferences?
- Can residents choose their own mealtimes?
- Are there food choices at meals?
- Is there adequate staff to help residents eat who need it?
- Are residents given enough time and encouraged to finish eating?
Activities
- Ask to see the calendar of events and activities.
- Are there scheduled activities in which the potential resident would be interested?
- Are residents taken on trips outside the facility for activities?
- Is transportation available?
Residents and Staff
- Ask residents how they feel about being there.
- Do residents appear to be treated well by the staff?
- How many staff members are generally available to take care of the residents in the facility during the day, evening, and overnight shifts?
- How are staff members trained? What are their qualifications?
- Are licensed nurses available? What are their work hours?
- What is the staff turnover rate?
Ownership
- Who sponsors or owns the facility?
- Who manages it?
- What is the management’s experience?
Financial Status
- Does the provider have substantial debt? If so, is there a solid plan for paying it?
- Are there adequate reserves to cover emergencies?
- What are the provider’s investment philosophies?
- Does the provider have a financial development program, such as a gift annuity, charitable remainder of trust, bequests, or other planned-giving methods?
Make a Second Visit
Visit the facility a second time, this time without making an appointment. Go at a different time of day than on your first visit, preferably on a weekend or in the early evening when there are not as many staff working. Slowly walk through the facility again. Observe and talk with the residents and ask any additional questions. Note whether there are any changes in the delivery of care or services or the quality and quantity of meals.
For more information on nursing facilities and guidance on choosing a specific facility, contact the California Advocates for Nursing Home Reform and the California Association of Health Facilities.
