How to choose a nursing home

Who this guide is for

For people who need 24-hour nursing care, either for a short stay to recover after a hospital stay (rehabilitation) or to live there long term, and for families choosing for them. If the person mainly needs help with daily activities and not nursing care, assisted living or home health care may also be options.

What the official data on our pages means

Overall star rating

Medicare’s 1 to 5 stars, built from the three ratings below. A home can be rated lower overall when it has serious inspection problems.

Health inspections

The state inspects every certified home about once a year and after complaints. Problems found are called deficiencies. This rating compares a home with other homes in the same state.

Staffing

Nurse and aide hours per resident per day, registered nurse hours, and staff turnover (how many staff left in a year), from payroll data the home sends to Medicare. More hours and lower turnover are generally better.

Quality of resident care

How residents do, for example falls with injury, pressure sores, and returns to the hospital, shown separately for short-stay (rehab) and long-stay residents.

Fines and payment denials

Penalties that Medicare lists for about the last three years. Several or large fines usually mean serious problems were found.

Abuse icon and Special Focus Facility

Medicare marks homes cited for abuse, and names homes with a record of serious problems as Special Focus Facilities (or candidates), which are inspected more often.

Questions to ask when you call or visit

• Is the home certified by Medicare and/or Medicaid, and does it have a bed for the care you need (short-term rehab or long-term care)?
• Can you see the latest state inspection report? Ask how any problems found were fixed.
• How many nurses and aides work on each shift, at night and on weekends? Is there a registered nurse on site at all times?
• Which doctors see residents, and how often? What happens in a medical emergency, and which hospital is used?
• What therapy (physical, occupational, speech) is offered, and how many days a week?
• Are residents clean, dressed and taking part in activities? Do staff speak to them kindly and answer call lights quickly?
• What do the daily rate and extra services cost, and what do Medicare, Medicaid or your insurance pay? Ask for it in writing.
• Is there a resident council and a family council? How are complaints handled? Ask for the long-term care ombudsman’s contact.
• Are meals appetizing, and can the home meet special diets, language needs and religious or cultural preferences?
• Visit more than once, including at a mealtime or in the evening, without an appointment.

Warning signs

• Strong smells of urine, residents left in bed or in nightgowns during the day, or call lights that ring for a long time.
• Staff who seem rushed, do not know residents’ names, or change often; many temporary (agency) staff.
• Recent abuse citations, repeated serious deficiencies or large fines on the inspection record.
• Pressure to sign an admission contract quickly, or a contract that asks a family member to be personally responsible for payment or to give up the right to go to court (ask before you sign).
• Unexplained bruises, weight loss, dehydration or a sudden change in a resident’s mood.

Costs and who pays

Medicare (Part A) can cover a short stay in a skilled nursing facility, up to 100 days in a benefit period, when you need daily skilled care after a qualifying inpatient hospital stay (generally at least 3 days in a row as an inpatient, not under observation). The first 20 days have no coinsurance; days 21 to 100 have a daily coinsurance set each year. Medicare does not pay for long-term custodial care (help with bathing, dressing and eating) when that is the only care you need.

Medicaid pays for long-term nursing home care for people who qualify by income, savings and need. Most homes accept Medicaid, but not every bed or every home does: ask.

Private pay, long-term care insurance and veterans’ benefits pay for many long stays. Ask for the daily rate and every extra charge in writing.

If you have a Medicare Advantage plan or other insurance, call the plan first: it may need to approve the care in advance and may only pay for providers in its network.

In general terms only. Deductibles, coinsurance and other amounts change every year, and Medicaid rules differ by state: check Medicare.gov, call 1-800-MEDICARE or your state Medicaid agency, and ask your plan.

How to complain or get help

• Talk to the home’s administrator or social worker first, and bring it to the resident or family council.
• State survey agency: the state agency that inspects nursing homes for Medicare and Medicaid investigates complaints, and complaint inspections appear on the home’s inspection record. Medicare can give you its phone number.
• The Long-Term Care Ombudsman in your state is free and independent: ombudsmen help residents of nursing homes, assisted living and other care homes (and their families) with complaints and with residents’ rights. Find yours through the Eldercare Locator, 1-800-677-1116.
• If you think someone is being abused, neglected or exploited and is in danger, call 911. You can also report it to the state agency and to Adult Protective Services (the Eldercare Locator can give you the number).
• Medicare: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, free, with help in Spanish and other languages.

Find care on US Patient Guide

Common questions

Sources

• Medicare Care Compare (Medicare.gov)
• Five-Star Quality Rating System for nursing homes (CMS)
• Skilled nursing facility (SNF) care: what Medicare covers (Medicare.gov)
• Long-term care: what Medicare covers (Medicare.gov)
• Long-term services and supports (Medicaid.gov)
• Long-Term Care Ombudsman Program (U.S. Administration for Community Living)
• Eldercare Locator (U.S. Administration for Community Living), 1-800-677-1116
• Residential facilities, assisted living, and nursing homes (National Institute on Aging)
• Medicare.gov in Spanish

Written in plain language by US Patient Guide from the official sources above, November 2, 2026. The facts on each provider page come from the official data shown on that page, with its date. Not medical advice.