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What should I look for during a nursing home facility tour?

Anthony Cirillo
Geriatric Medicine
The following are suggestions for touring a nursing home:
  • Visit a facility all hours of the day. Go at night and on weekends and see what is going on, what is being offered. Visit often.
  • How diligent was security when you entered? Was their security? Are staff wearing their identification badges?
  • We have been trained that nursing homes smell of urine. Well guess what? In the typical parts of a tour you might take they probably will not smell as the staff has thought out your tour in advance. So perhaps see if you can stray off the beaten track and be curious about seeing other areas.
  • See if the Director of Nursing is out in the halls. Is he/she walking by everyone not making eye contact, not saying anything? That will tell you something.
  • Same with the administrator. Is the administrator out there asking how you are doing, how are you feeling? That interaction is important. Look for it. Sit down with the administrator and ask about their views on long-term care.
  • Ask for a copy of a report known as Form 2567 or the state inspection survey. This report will reveal the results of unannounced visits by state surveyors who spoke with residents and checked on sanitary conditions and care issues.

A nursing home search (and tour) has much in common with a college search. Start early, before a crisis forces a quick decision. Talk with friends, coworkers, nurses you may know, and others in the same boat. What facilities do they have experience with, and what has that been like? Know in advance what the important (major) characteristics are for the individual being placed. Rehab? Memory loss support? Language or culture other than the regional norm?

Visit as many facilities as you can get to within reasonable commute. Pop in. Take that time you'll spend sitting in the lobby to observe. Note the interaction between staff (especially CNA's) and residents. Respectful, but warm and friendly? Look at the activities calendar, and ask about that department's programs. Commonly, women outnumber men in nursing homes by almost 3 to 1. If you are searching for a place for your father / brother / uncle / husband, make sure appropriate social groups are in place and active. Watch for odors. Not just for the infamous urine smell (any nursing home worth its salt will have good toileting programs, as well as the appropriate deodorizer products on hand), but from the kitchen. Do meals smell tempting?

While touring, do staff smile at you and say 'Hi'? Do they answer questions patiently, and demonstrate enthusiasm for their work? Look past some of the decor. A strong facility will be structurally sound and in good repair, but not necessarily 'pretty'. Some of the best care may be delivered in settings best described as a 'challenge.' Keep notes - otherwise the details tend to blur after a few visits.

Check out the results of nursing home surveys for those facilities you consider serious contenders. See CMS's Nursing Home Compare for more information at: www.medicare.gov/NHCompare/Include/DataSection/Questions/SearchCriteriaNEW.asp?version=default&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home&CookiesEnabledStatus=True

In the end, if you are making a placement decision for a loved one, trust your heart. You will know the right fit when you find it.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.