Questions to ask nursing home staff when touring a facility

Making the move to a nursing home isn’t something that should be taken lightly and due diligence definitely is in order. With such a massive life change, though, where does one even begin with their search? With questions — lots of them! — according to experts.

“Research is absolutely key when searching for a new home for loved ones,” says Stacey Eisenberg, owner of A Place at Home in Austin, Texas and a senior care expert who routinely accompanies families on facility tours. “There is no limit to the questions that can be asked, literally hundreds. Most people don’t ask enough questions and then get surprised later on.” 

Here, Eisenberg and other experts share the questions to ask nursing home staff and administrators when narrowing down your options. 

Questions to ask about the facility

One of the biggest things to keep in mind when touring a nursing home is not to judge a book by its cover, notes Eisenberg, who adds: “Many nursing homes are beautiful and have poor care, while the opposite is also true.”

Keeping that in mind, it’s also important to see the facility’s most recent state inspection report, notes Irving Seldin, a senior care executive with over 30 years experience and current owner and CEO of Visiting Angels in Palm Beach Gardens, Florida. “The law requires the facility to share it with you,” he explains. “Look for citations that indicate poor care or safety issues.”

Here are other things to ask or take note of, according to Eisenberg and Dr. Kevin Huffman, an osteopath with extensive experience in holistic geriatric care as well as the founder of Ambari Nutrition:

• Is the building clean and well cared for? 
• Are there resident rooms for potential residents to look at? (And if so, find out if the room you see is the one your loved one would be staying in.)
• How many residents per room?
• Is there a common eating space? 
• Can residents choose from a couple options at each meal? 
• Is it possible to have favorite meals/foods?
• Is there an outdoor space? 
• Does the outdoor space have sun protection and is it secure?
• Are rooms available for dining out? 
• Are rooms accessible for residents with mobility limitations? 
• How is the temperature of the space? 
• What security procedures are in place? 
• What are the fire safety procedures? 
• How does the facility handle an emergency?
• Are there elevators?
• Where is the location in relation to your own home?
• Is there a place for families to gather?

Additionally, Eisenberg suggests taking note of the following while touring the facility:

• Smells. Is there a strong smell when you first walk in? Is it trying to mask other smells? “I have worked in residences that wanted popcorn popping or cookies baking all the time, so that it smelled inviting,” she says, adding: “Whereas, other places smell chemically in attempts to cover other smells.”

• Sounds and activities. Listen for sounds of life or activities and engagement happening. “You never want to choose a place where everyone is just sitting around all the time,” Eisenberg says. “Be aware of the time of day and what should be happening. Try to visit at different times of day, including unannounced or without an appointment.”

• Cleanliness. “While everything may look clean, check obscure places, such as picture frames and shadow boxes,” she says. “If they are dusty, then they may only be cleaning surfaces.”

“The executive director sets the tone, so insist on meeting with them rather than relying on the salesperson or tour guide.”

— Irving Seldin, a senior care executive

Questions about the staff

Even if you’ve heard great things about the staff, you still need to do your due diligence, Seldin notes, as “changes in ownership, staff or policies can affect the quality of care. “The executive director sets the tone, so insist on meeting with them rather than relying on the salesperson or tour guide,” he adds.

Seldin also notes that it’s important to “closely observe” how the staff interacts with residents, as they’re key in quality care. “Ask about staff training and turnover,” he says. “The use of temporary staff is a red flag.”

Here’s what else to ask about nursing home staff, according to Seldin, Huffman and Eisenberg:

• What is the staff-to-resident ratio? 
• What are the qualifications and experience of the nurses and caregivers?
• Does the facility offer 24/7 supervision? 
• Is there a registered nurse on site 24/7?
• Does the staff check on residents in timely intervals (a.k.a. Do they do rounds?)
• Is there training for specific needs, such as dementia care?
• Do doctors come to the nursing home?
• Does the staff assure the senior actually eats? 
• Can they be assisted if needed/fed?

During your tour, Eisenberg also suggests speaking with current residents or their families “to get a sense of the staff’s expertise and commitment.”

Keep in mind, though, “not every individual’s experience will be your loved one’s experience,” notes Christopher Norman, a geriatric nurse practitioner with the National Council on Aging. “But if lots of people are verbalizing the same concerns, think carefully about these identified trends.” 

“Not every individual’s experience will be your loved one’s experience. But if lots of people are verbalizing the same concerns, think carefully about these identified trends.” 

— Christopher Norman, a geriatric nurse practitioner with the National Council on Aging

Questions about resident care

In addition to knowing who’s caring for residents, it’s important to know how they’re being cared for, notes Huffman, who suggests asking the following questions:

• What is the full range of medical care services available on-site? 
• Does the facility have a doctor or on-call physician? 
• How are medication management and physical therapy needs addressed? 
• Are mental health services available?
• Are there social activities provided that encourage resident engagement?
• Are there religious and/or cultural accommodations?

Questions about amenities and daily living

It’s also important to think about the amenities and services offered by the nursing home, notes Eisenberg. Here’s what both she and Huffman suggest asking: 

• What are the daily schedules and meal times? 
• Does the facility provide assistance with dressing, bathing and other daily living tasks? What are the dining options? 
• Are meals flexible for dietary restrictions and preferences?
• Can residents schedule their activities? 
• Is transportation offered for appointments? And if so, is there an extra fee for this?

Questions about cost 

No matter how much you love a nursing home and everything it has to offer, discussing finances is crucial. Consider asking the following upfront:

• Is the nursing home Medicaid or Medicare certified?
• What is the overall cost, including deposits, move-out notice periods and price increases. (“Get details about increased costs as care needs increase,” Seldin stresses. “Many facilities have tiered pricing based on levels of care.”)
• Are there any special fees for extra services, such as a handling of medication costs?
• Which payments are accepted, including coverage through long-term care insurance?
• What kinds of financial aid are available? (“Veterans receive assistance with care needs,” Eisenberg notes, “but it is not often advertised.”)

Asking financial questions are important, but, as Norman notes, “most counties have an Area Agency on Aging with helpful resources on long-term care planning which include paying for this level of care.” 

The bottom line on questions to ask a nursing home

Taking the time to dig around a bit will help you find the best form of care. “Questions — and answers — help you understand what a place is like, who’s taking care of residents, and how folks might be treated if they lived there,” says Norman. “Make sure you have all the information you need to make the right choice.”

Ultimately, fully vetting any nursing home will go far to protecting your senior loved one. As Huffaman concludes, “A decision made in haste risks placing your loved one in an environment that isn’t suited to meet their specific needs. Researching and comparing facilities allows you to find one that feels like home, that offers the right level of care and that respects the dignity of its residents.”