Nursing Home Best Practices

As you hone your options, it’s important to understand nursing home best practices — or what nursing home ‘excellence’ looks like.


Operates legally: The nursing home is licensed and is in compliance with all applicable federal and state regulatory requirements. Voluntary accreditation through the Joint Commission on Accreditation of Health Care Organizations, JACHO, is a plus.


Provides High Quality Resident Care: The nursing home has a 4- or 5-Star Quality Rating from Medicare and/or no serious deficiencies on state surveys.


Demonstrates respect for residents: All residents are treated with respect by staff. This includes offering as much freedom, choice, privacy and involvement in care planning as is consistent with safe care.


Promotes person-centered care: Residents’ rooms are personalized and homey; residents have menu options at each meal and a choice about when and how they bathe, dress and eat. The facility provides a choice of varied activities daily.


Supports family and resident councils: There is an active resident and/or family council that meets regularly.


Low staff/caregiver turnover rates: A low staff turnover rate is usually a measure of good management practices and employee satisfaction and typically, associated with higher quality care for residents.

Tips to Get Your Nursing Home Search Underway

  • Ask for recommendations from friends, clergy, your doctor and/or a local hospital; talk to your state ombudsman.
  • Visit Nursing Home Compare to locate Medicare-certified nursing facilities by area, check out quality ratings and review survey results.
  • Know what ‘ratings’ mean. Be aware that Medicare quality ratings are based on self-reported data. Interpret all data with caution because numbers do not tell everything. For example, a nursing home may have a higher number of reported falls or residents in pain because they accept very ill or frail patients, not because they are delivering poor care. There is no substitute for in-person investigation and research.
  • Go to your state website to check licensure and deficiency status of non-Medicare certified nursing homes.
  • Call nursing homes you want to visit, and confirm that they offer the care you need and have a bed available.
  • Schedule appointments to visit the nursing homes that you think will match your needs.
  • Review the checklist to prepare for your visit.
  • Tour the nursing home. Ask to see all floors, all public areas and the kitchen. Look into resident rooms and talk to residents. Visit more than once, including during a mealtime, on a weekend or late in the day, if possible.
  • Remember that the person giving you a tour is a salesperson who wants to show you the best side of the facility. Insist on seeing as much of the nursing home as you feel you need to in order to make a good decision.