How to Choose the Right Nursing Home for Your Loved One

Choosing a nursing home for your loved one is one of the most important — and emotional — decisions a family can make. Whether it’s due to advanced age, illness, or the need for specialized medical care, finding the right facility requires thorough research, careful planning, and honest conversations. A good nursing home can enhance your loved one’s quality of life, while a poor choice can lead to neglect, isolation, and even abuse.

In this blog, we’ll walk you through the key factors to consider when selecting a nursing home and provide tips to ensure your loved one receives the care, dignity, and respect they deserve.

1. Understand Your Loved One’s Needs

Before researching facilities, identify the level and type of care your loved one requires:

• Skilled nursing care: Needed for individuals with serious medical conditions requiring 24-hour supervision by licensed nurses.
• Assisted living: Appropriate for seniors who need help with daily activities but do not require constant medical care.
• Memory care: Specialized for residents with Alzheimer’s disease or other forms of dementia.
• Rehabilitation: Short-term care for those recovering from surgery, injury, or illness.

Speak with your loved one’s physician to get a comprehensive medical evaluation, which will guide your choice of facilities.

2. Start with the Medicare Nursing Home Compare Tool

The Centers for Medicare & Medicaid Services (CMS) provides a helpful online resource: the Medicare Nursing Home Compare Tool, which allows you to look up facilities in your area, view inspection reports, and compare overall ratings on:

• Health inspections
• Staffing levels
• Quality of resident care

This tool gives a star rating (1 to 5 stars) based on recent federal inspections, with 5 being the best. Facilities with below-average scores in multiple categories may indicate systemic issues.

Tip: Don’t rely on star ratings alone. Use them as a starting point and follow up with personal visits and interviews.

3. Visit the Nursing Homes in Person

A facility may look good on paper, but nothing replaces an in-person visit. When touring a nursing home, consider the following:

Cleanliness and Safety

• Are the common areas clean and well-maintained?
• Are hallways free of clutter?
• Are there safety features like handrails, call buttons, and secure exits?

Staff Interaction

• Do staff members address residents respectfully by name?
• Do residents appear comfortable and well-groomed?
• Is there adequate staff-to-resident interaction, or do residents seem isolated?

Residents’ Quality of Life

• Are there daily activities available?
• Are meals nutritious and tailored to dietary needs?
• Are residents encouraged to participate in decisions about their care?

Ask to observe a meal or activity if possible. You’ll learn a lot about the facility’s culture just by watching how staff and residents interact.

4. Check for Licensing, Certifications, and Violations

Each state licenses and inspects nursing homes to ensure compliance with health and safety standards. In Illinois, for example, the Illinois Department of Public Health (IDPH) maintains a Nursing Home Search tool where you can:

• Confirm licensure
• View inspection reports
• Review substantiated complaints or violations

Look out for red flags such as repeat violations, understaffing citations, or reports of resident abuse or neglect.

5. Review the Staff-to-Resident Ratio

One of the most important indicators of quality is staffing. Understaffed facilities often struggle to provide timely assistance with daily activities such as bathing, dressing, eating, and using the restroom — leading to increased risks of pressure ulcers, malnutrition, and falls.

According to CMS, a high-quality nursing home typically provides:

• At least 4.1 hours of direct care per resident per day, including:
  • 0.75 hours by a registered nurse (RN)
  • 0.55 hours by a licensed practical nurse (LPN)
  • 2.8 hours by certified nursing assistants (CNAs)
    (Source: Health Affairs Journal)

Facilities that fall significantly short of these benchmarks may compromise resident care.

6. Assess Specialized Care Services

If your loved one has a specific condition — such as Parkinson’s, diabetes, or dementia — ensure the facility has experience managing that condition. Ask:

• Are staff trained in managing your loved one’s condition?
• Is there a care plan tailored to the resident’s diagnosis?
• Is there access to physical, occupational, or speech therapy?

Inquire about medical oversight. Some facilities have full-time medical directors or on-call physicians, while others rely on outside providers.

7. Understand the Cost and What’s Covered

Nursing home care can be expensive. According to Genworth’s 2023 Cost of Care Survey, the average monthly cost for a semi-private room in a nursing home is $8,669, while a private room costs around $9,733.

Determine how the facility is paid for:

• Medicare only covers short-term stays for rehabilitation (up to 100 days).
• Medicaid may cover long-term care if the resident qualifies financially.
• Long-term care insurance may help defray costs.
• Out-of-pocket is the most common payment source.

Ask for a detailed breakdown of fees and services, and make sure you understand which services are included versus billed separately.

8. Talk to Residents and Their Families

One of the best ways to learn about a facility is by talking to current residents and their families. Ask questions like:

• Are you satisfied with the care here?
• Do staff respond promptly when called?
• Are meals and activities enjoyable?
• Have you had any concerns about safety or cleanliness?

If the facility won’t allow you to speak with other families, consider that a red flag.

9. Review the Resident’s Rights

Federal law protects the rights of nursing home residents under the Nursing Home Reform Act of 1987, which includes the right to:

• Be treated with dignity and respect
• Participate in their own care planning
• Voice grievances without fear of retaliation
• Be free from physical or chemical restraints unless medically necessary

Make sure the facility provides a written copy of the Resident’s Bill of Rights and discuss how complaints are handled.

10. Trust Your Instincts

Sometimes the decision comes down to your gut feeling. If something doesn’t feel right — an evasive answer, a dismissive tone, or residents who look fearful — trust your instincts and move on.

Red Flags to Watch Out For

Be on alert for signs that a nursing home may not be up to standard:

• High staff turnover
• Frequent reports of falls, bedsores, or unexplained injuries
• Residents left unattended for long periods
• A strong odor of urine or feces
• Delays in answering call lights
• Residents who appear sedated or overmedicated

These warning signs could point to understaffing, neglect, or abuse — all of which are serious issues that could put your loved one in danger.

What to Do If You Suspect Neglect or Abuse at a Nursing Home

If your loved one is already in a nursing home and you notice signs of neglect — such as unexplained bruises, rapid weight loss, dehydration, bedsores, or behavioral changes — take immediate action:

1. Document everything: Take photos, write down what you observe, and keep a log of incidents.
2. Report it: Contact the state’s long-term care ombudsman or local adult protective services.
3. Seek legal help: Speak with an attorney experienced in nursing home abuse or neglect cases.

You can find more information on Illinois-specific reporting through the IDPH’s Nursing Home Complaint Hotline at 1-800-252-4343.

Contact the Top-Rated Chicago Nursing Home Abuse and Neglect Lawyers at John J. Malm & Associates

Selecting the right nursing home is not just about comfort and amenities — it’s about ensuring your loved one is safe, respected, and receives quality care. Take your time, ask tough questions, visit more than once, and involve your loved one in the decision when possible. It’s not just a place for them to live — it’s their new home. By doing your homework, advocating for your loved one, and being proactive, you can make a choice you feel confident about — and give your loved one the care and dignity they deserve.

If you believe your loved one is experiencing abuse, neglect, or substandard care in a nursing home, don’t wait to act. Trust your instincts — even subtle signs like unexplained bruises, personality changes, poor hygiene, or repeated infections can indicate serious problems. Your loved one deserves dignity, safety, and proper care. Contact our experienced nursing home abuse attorneys immediately to protect their rights and hold the facility accountable. At John J. Malm & Associates, we are committed to helping families in Chicago and throughout Illinois seek justice and ensure their loved ones are treated with the respect they deserve. Contact us today for a free consultation — we’re here to listen, investigate, and fight for your family.