How to Choose a Nursing Home

Moving your loved one from their home into a nursing home can be challenging. While a nursing home, no matter how comfortable, can never replace home sweet home, there are a number of things you can do to make this difficult transition as painless as possible. Diligence and attention to “the little things” are just as important as reviewing the home’s reviews and records. Quality nursing home care requires efficient systems, adequate staffing, and updated equipment and facilities.

Click here to compare ratings and costs of nursing homes across North Carolina.

Use Your Five Senses


Look at everything.

Examine the nursing home reviews and public records. Talk to residents and their caregivers who selected the home for their loved ones. Interview management. Ask how many patients are assigned to nursing aide staff and if they work overtime on a regular basis (this could be a sign of an overworked staff). Ask about staff attrition and about the frequency of temporary staffing. Medicaid and Medicare certified nursing homes must post the number of nursing staff they have on duty to care for residents on each daily shift.

Examine the facility, itself. Are the floors and surface areas clean? Are common areas neat, tidy, and attractive? Are there potential fall hazards, such as loose rugs or debris on the floor? Is the furniture comfortable, sturdy, and safe?

Examine the appearance of residents. Are they kept clean and neat and dressed appropriately for the time of day? Is hair combed? Do residents seem engaged and content, or withdrawn?


Nursing homes can sometimes have strong odors. It comes with the territory. But notice if these odors seem stale or steeped in.


What do you hear? It is not uncommon to hear some residents moan or call out for help occasionally, especially residents with dementia. Notice how the nursing home staff addresses these cries for help. Are they repeatedly ignored or are these residents attended to? Listen to how staff members address residents, and take note of body language between the resident and staff members. Are staff members idle and chatting among themselves, or are they busy attending to residents’ needs or offering a kind word or gesture? Do you hear laughter and light-hearted chatter among residents and guests? Or is there a pall of silence?


Ask if you and your loved one can sample a meal at the nursing home. Is the food palatable? Visually appealing? Are there a variety of nutritious choices? Do other diners seem to enjoy the food and the dining experience? Are special dietary needs addressed? Are dining staff helpful and attentive to special needs during dining, such as those who may need assistance eating or drinking? Are snacks served between meals? Ask if your loved one’s favorite foods are served.


Are surfaces sticky, greasy, or otherwise unclean? Floors? Table tops and dining areas? Do board games and other devices seem clean and well maintained?

Medicare Guide to Choosing a Nursing Home

Click here for the Medicare guide: Your Guide to Choosing a Nursing Home or Other Long-Term Services & Supports.