Selecting a Nursing Home

Like Their Patients, Every Nursing Home is Unique

Making the decision to enter a nursing home is never easy, and once it’s made comes yet another difficult task – the task of choosing the right facility. While the process of selecting a nursing home may seem overwhelming at first, it helps to remember that all facilities share the common goal of providing quality, round-the-clock patient care in an environment as homelike as possible. Beyond that, every nursing home has certain areas of expertise, offers certain special services and may be better suited to a certain type of clientele. In other words, specific factors, such as payment method, location and availability of special care units, will make one nursing home better suited to a patient than another.

For instance, if the patient is eligible for Medicare or Medicaid, the selected nursing home must participate in the program through which the patient is receiving assistance. Most Tennessee nursing homes accept Medicare patients, but, due to strict medical qualifications, just 15 percent of nursing home patients receive Medicare coverage to pay for their nursing home stays. Almost 90 percent of Tennessee nursing facilities participate in the Medicaid program, and the majority of Tennessee nursing home patients, approximately 68 percent, receive care that is paid for by Medicaid.

Location may be the most often-cited factor that influences facility selection. Nursing home patients and their families often prefer a facility that is close to the family’s home or hometown. Location can be a key factor in a facility’s atmosphere, and the lifestyle of the community in which the facility is located – urban, suburban or rural – usually is reflected in the lifestyle of the facility.

Another consideration is the special services or features of a facility. The development of special care units to better treat certain disabilities is a growing trend in nursing homes. Facilities may have specialized units to care for patients with certain injuries or illnesses, such as Alzheimer’s disease, or offer special therapy programs or treatment not available at other facilities.

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Where to Begin

The first step in the selection process is to seek referrals. Valuable information can be gained by talking with long-term care professionals, hospital discharge planners and social workers, your family physician, and friends or acquaintances who may have first-hand knowledge about choosing a facility. The information you obtain from these sources will help clarify the issues and focus your perspective.

And remember, nursing home placement can be tremendously stressful for both the person needing care and the family. Seek agreement by involving the patient and family members in decision-making issues of facility selection. This not only will help relieve immediate concerns but also ease the transition into the chosen nursing home.

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Facility Visits: A Checklist

The best way to determine the appropriate match of nursing home services and patient needs is through facility visits. Facilities may be screened by calling and asking questions, thus saving time and effort. However, it’s a good idea to plan personal visits to at least three facilities, involving as many family members as possible.

All facilities offer tours to prospective patients and their families. Some help visitors experience what the facility has to offer by allowing them to sit in on activity programs or other events. Ideally, you should visit each nursing home more than once to observe activities throughout the day. At least one visit should include a mealtime, which allows you to sample the food and see the patients in a social setting.

Although the initial visit should be arranged with the administrator so that you may ask specific questions of staff, management and volunteers, follow up visits can be unscheduled. During each visit, evaluate interaction between patients and their caregivers. If possible, meet with the facility’s family council, or if no council exists ask to speak with family members of other patients.

The selection of a nursing facility is a crucial decision. All questions should be answered and any doubts resolved before making a final choice. Following is a checklist of suggested inquiries that can help you conduct effective and successful facility visits.



Facility Appearance and Design

Staff Attitudes

Bedrooms and Bathrooms



Patient Care Services

Patient Rights


Your Part: Family Involvement

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