Choosing a Nursing Home

Choosing a nursing home for yourself or a loved one is a very important decision. Discuss the issue thoroughly with the individual involved and their personal physician. Consider what the travel limits are for those who will be visiting the person receiving services, and identify the communities and nursing homes within those limits.

Table of Contents

Step 1: Gather information and prepare for personal visits

  • Contact the facility's admissions representative to schedule an appointment for an informational meeting and tour of each facility. Ask for a copy of the facility's brochure, admissions policies, and the resident's bill of rights.
  • Contact the Executive Office of Elder Affairs and ask to speak with the ombudsman who covers the facilities you are interested in
  • Contact the Division of Health Care Facility Licensure and Certification to get the "Survey Performance Tool for Nursing Homes" or a copy of survey findings and complaint reports for the facilities under consideration.

Key Actions   for Step 1: Gather information and prepare for personal visits

Additional Resources   for Step 1: Gather information and prepare for personal visits

Step 2: Suggested topics and questions to ask at each visit

Health Care and Services

  • Can residents retain their personal physician if they wish?
  • Will a resident be moved out of the facility if additional care is needed?
  • Do residents have input in the development of care plans?
  • Are rehabilitation programs and therapies offered, as appropriate?
  • What are the policies on "do not resuscitate" and "advance directives"?
  • If applicable, does the facility meet the Alzheimer's Association criteria?
  • Does the facility offer specialized programs or services?


  • What is the staff to resident ratio?
  • What are the facility's hiring and staffing policies?
  • How are prospective employees screened?
  • What kind of training do new employees receive?


  • Is there adequate privacy and space in resident rooms?
  • What personal possessions are permitted in resident rooms?
  • How are items protected from theft?
  • If rooms are shared, how are roommates selected?
  • What happens if roommates are not compatible?
  • What are the policies on transfer and relocation of residents?
  • Are there activity rooms and lounge areas for resident use?
  • Are the bathing and food preparation areas clean and accessible?

Meals and Resident Activities

  • Are meals served in an appealing manner and at proper temperature?
  • Ask to sample a meal.
  • Are there food choices?
  • Are there accommodations for special diets?
  • Are snacks and drinks available between meals?
  • Is there an active residents' council?
  • Are special events held at or outside the facility and what is scheduled?
  • Are there religious or cultural activities offered?

Family Visits

  • What are the facility's policies concerning family visits?
  • Are there designated visiting hours?
  • What space is available for visits?
  • Are there limitations on the number of visitors or frequency of visits?
  • Are family members permitted to join relatives for occasional meals?

Payment Policies

  • Is the facility approved to accept Medicare or Medicaid patients?
  • What is the billing and payment policy?
  • What is included in the daily/monthly rate?
  • Are there any additional charges?
  • How long will the bed be held if the resident is hospitalized?

Facility Environment

  • Do the residents appear to be well cared for, properly groomed, and dressed appropriately for the season and time of day?
  • Do staff seem to be friendly, caring and accommodating to residents, visitors and others?
  • Do staff members respond promptly to resident's requests?
  • Is the facility clean?
  • Are there strong odors in the facility?
  • Is the facility well maintained, pleasing and cheerful?
  • Are the exits clearly marked and accessible?

Survey Reports

  • When was the facility's last survey conducted?
  • Is the most recent survey report available in the facility? If so, where?
  • Have cited deficiencies been corrected?
  • If corrected, when and how were they corrected?
  • How will the facility prevent them from recurring?
  • If deficiencies are not yet corrected, what is the facility's plan for correcting?

Step 3: Visit each of the nursing homes

  • Visit the nursing home and meet with the admissions representative or administrator
  • Tour the nursing home and observe staff interactions with residents
  • Take the time to speak with residents and family members about their experiences
  • Ask questions and make observations

Step 4: Narrow your choices and make a selection

  • Narrow choices and re-visit the facilities under consideration again at a different time of day if possible
  • Contact the admissions staff for advise about the admission process
  • Meet with the administrator and key staff to discuss specific concerns you may have about care needs and personal preferences
  • Ask to participate in care planning decisions
  • Be sure to visit often and remain involved in your loved one's ongoing care

Resources available

There are many resources available from your community to help with decisions about the quality of nursing home care or about alternative models of care. Exploring all of your options will ensure that you make the most informed choice possible.

This is a partial listing of frequently used resources. When contacting any of the organizations listed below, be sure to ask if they have suggestions about additional resources you may want to contact.

Consumer and Provider Service Organizations

Alzheimer's Association of Eastern Massachusetts
Telephone: (617) 494-5150
Helpline: (800) 548-2111

LeadingAge Massachusetts
Telephone: (617) 244-2999

Living is for the Elderly (LIFE) Nursing Home Resident Advocacy Group
Telephone: (781) 646-1000 ext. 4733

Massachusetts Senior Care Association
Telephone: (617) 558-0202

Massachusetts Elderline
General Consumer Information on Free Prescription Drug Program and
Services for the Elderly
Telephone: (800) 243-4636

Hospice Federation of Massachusetts
Telephone: (781) 225-7077

Additional Resources   for Resources available

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