How-to-choose-a-nursing-home checklist

A nursing home may be used for long-term care or for short-term skilled nursing after a hospital stay. Skilled nursing means round-the-clock care from licensed nurses and therapists.

Before you tour, write down the basic goal: rehab after discharge, ongoing daily care, or both. This helps you compare places with the right level of support.

If you want help narrowing options, get matched. Northhaven Care is a free matching service, not a care provider. Some participating facilities pay a flat fee to be matched. That never changes what the family pays, and it never changes our guidance about Medicare or Medicaid.

Check Medicare.gov Care Compare for the CMS Five-Star rating. It has three parts: health inspections, staffing, and quality measures. Staffing is often the most telling, especially RN hours per resident per day. RN means registered nurse.

A high overall star rating can still hide weak staffing. A lower rating can also need a closer look if the facility serves people with more complex needs. Ratings are helpful, but they are only one part of the picture.

If you want help understanding the numbers, services/quality-and-ratings-help can help you read them in plain language.

Bring this checklist when you visit. You do not need to ask for medical records or share private documents with us to use this tool. We only use general contact details if you ask to speak with us.

Tour checklist:

- Is the building clean, bright, and easy to move through?
- Do staff greet residents by name?
- Are call lights answered in a reasonable time?
- Do residents seem clean, dressed, and cared for?
- Is there a licensed nurse visible on the unit?
- Are activities, meals, and therapy explained clearly?
- Does the facility feel calm, not rushed or chaotic?
- Do they explain how they handle falls, infections, pressure sores, and emergencies?
- Can you see a sample care plan and staffing schedule?
- Is the room type clear: private room, shared room, or semi-private room?

Ask direct questions. Short, clear answers are usually a good sign. If the staff cannot answer, ask who will follow up and when.

Questions to ask:

- What is the current staffing level on this unit?
- How many residents does one aide or nurse usually care for?
- Is an RN on site every day?
- What therapies are available, and how often?
- How do you communicate with families?
- What is included in the monthly rate?
- What costs extra, such as supplies, toiletries, or therapy?
- Do you accept Medicare for short-term rehab?
- Do you accept Medicaid for long-term care, if needed?
- What happens if my relative’s needs change?

Do not rely on any promise of an open bed, a price guarantee, or a guaranteed outcome. Real availability and costs change.

Nursing home and skilled-nursing costs vary a lot by state, room type, and level of care. A common planning range is roughly $7,000-$13,000+ per month, but the real number may be lower or much higher depending on the facility and how the care is paid.

Medicare may cover short-term skilled nursing care for up to 100 days after a qualifying hospital stay. Cost-sharing usually starts after day 20. Medicaid may help pay for long-term nursing care if a person meets the state’s income and asset rules. Rules vary by state, and they change over time.

For official payment rules, check Medicare.gov and your state Medicaid office. If there is concern about long-term care rights or discharge issues, your state long-term-care ombudsman can also help.

Choosing a nursing home for someone you love is hard. Taking time to compare facilities is normal and wise. If English is not the family’s strongest language, ask for help in the language you are most comfortable using. Qualification for care is separate from immigration status, and many services can still be explained in plain language.

Northhaven Care can help you compare options and understand ratings. We are a free service, and we do not collect medical history, diagnoses, medication lists, insurance numbers, Social Security numbers, or immigration documents. We only ask general contact details, the state, who the care is for, the general kind of care, and language if you want help.