A nursing home tour is one of those situations where asking the right questions matters more than getting the right answers. The answers will vary from facility to facility. The questions stay the same, and the good ones will tell you more than any brochure.
Start with staffing. Ask what the staff-to-resident ratio is on each shift, including nights and weekends. Ask how many registered nurses are on duty at any given time and whether there is a qualified nurse on-site around the clock. Staff turnover is worth asking about too, because a facility that can’t hold onto its caregivers is telling you something about working conditions that will eventually affect your parent.
Ask about care planning. Every resident should have an individualised care plan that gets reviewed regularly. Ask how often that happens, who is involved in the reviews, and whether your family can attend. If the answer to that last question is anything other than a clear yes, consider it a red flag.
Move on to daily life. What does a typical day actually look like? What activities and social programmes are on offer? Can residents make choices about when they eat, when they sleep, and what they do with their time? Ask about the food. Ask whether dietary needs and preferences are accommodated. And ask about the visitor policy, specifically whether you can visit unannounced at any time.
Safety questions matter. Ask how the facility handles falls, medical emergencies, and elopement. If your parent has dementia, ask whether there is a secured unit and what protocols are in place for wandering. Ask about infection control procedures. Ask what happens if there is a serious incident and how quickly families are notified.
Then talk about money. Ask what is included in the base rate and what costs extra. Therapy, medication management, personal care products, and transport to medical appointments can all carry separate charges that add up. Ask whether the facility is both Medicare and Medicaid-certified, and ask what happens if your parent needs to transition from private pay to Medicaid.
While you’re asking questions, pay attention to everything else. Notice the smell when you walk through the door. Watch whether staff knock before entering rooms and address residents by name. Look at whether residents seem engaged or parked in front of a television with no interaction. Former nurses will tell you that the state of the bathrooms and the mood of the staff at 7pm on a Tuesday tell you more than anything the admissions team will say during a scheduled tour.
Visit more than once, at different times of day, and bring someone with you. Two sets of eyes catch things one pair will miss.