Nursing homes vary widely in quality. Because residents are usually at least somewhat dependent on the care and therefore vulnerable to abuse, it’s important to choose a home that adheres to high standards and promotes respect. Here are a few of the things you may want to look for.

Aides and Staff

1. Well-trained, trustworthy aides. How are they trained? Is ongoing education provided? Does the nursing home conduct background checks?
2. Friendly aides. Do they interact with residents as they pass by?
3. Enough aides. What’s the ratio of aides to patients—during the day and at night?
4. Attitude of respect. For example, the Centers for Medicare and Medicaid Services recommends considering whether aides call patients by name and knock before entering their rooms.
5. Friendly staff. Do they answer your questions openly?

Care

1. Support of personal control. Can residents choose when they get up, eat, bathe and go to bed?
2. Happy residents. They should also appear well-groomed.
3. Doctor on staff.
4. Ability to see your own doctor.
5. Ways to meet other needs. Where do residents get hair, dental and eye care?

Environment

1. Welcoming living environment. Will you have a window? Can you decorate your room?
2. Clean building free of bad smells.
3. Safety measures. Look for clearly marked exits, smoke detectors, a sprinkler system, and handrails in the hallways and bathrooms. Request fire-safety and health inspections. The Centers for Medicare and Medicaid Services also recommends asking whether the home has an emergency evacuation plan and holds fire drills with bedridden residents. However, the home may not be required to include such residents.
4. A specialized, easy-to-navigate dementia-care unit (if needed), with specially trained staff.
5. Nature and animals available. Is there a sunroom or secured garden that aides help residents access? Do animals live in the nursing home? Are pets allowed to visit? Do therapy animals come?

Governmental and Legal Considerations

1. Good reputation. Check the Medicare rating. (But keep in mind that the ratings system isn’t perfect. It’s just one of the tools to use.)
2. Medicaid and Medicare certification.
3. State licensing.
4. A good contract. The National Institute on Aging suggests talking to your long-term care ombudsman for help deciphering it.

Other

1. Desirable neighborhood. Is it near friends and family?
2. Good food with meal options—including for special dietary needs—and available snacks.
3. Water available constantly, to prevent dehydration.
4. Fun activities, including for people who are bedridden.

To get a good idea of what the nursing home is like, visit it at least twice, at different times of day. The second visit should be unscheduled. Talking to other residents is also helpful. How do they like the place?