What Should You Look for When Choosing a Nursing Home in 2025?

Selecting a nursing home for a loved one ranks among the most challenging decisions families face. With over 1.2 million nursing home residents across the United States and demand increasing as Baby Boomers age, understanding how to evaluate facilities has never been more critical.

The process begins with determining the level of care needed. Nursing homes provide round-the-clock skilled nursing care for seniors who require constant medical supervision. This differs significantly from assisted living communities, which offer support with daily activities but not intensive medical care. Before starting your search, consult with a physician to assess whether nursing home placement is necessary or if alternative care settings might better serve your loved one's needs.

How Do You Research Nursing Home Options?

Start by identifying facilities in your preferred geographic area. Proximity matters because regular family visits improve both quality of life and quality of care for residents. Medicare's Care Compare tool allows families to search and evaluate nursing homes based on location, ratings, and specific services offered.

When reviewing potential facilities, examine their star ratings carefully. The Centers for Medicare & Medicaid Services maintains a Five-Star Quality Rating System that evaluates nursing homes on health inspections, staffing levels, and quality measures. Facilities with five stars demonstrate much above average quality, while one-star facilities indicate quality much below average. However, ratings should not be your only consideration when making this important decision.

Financial planning forms another crucial component of your research. In 2025, the median cost for a nursing home ranges from $9,555 to $10,965 per month depending on room type. These figures represent a 15.9 percent projected increase from previous years, with costs expected to reach approximately $11,077 monthly by 2030 for a semiprivate room. Geographic location dramatically affects pricing. Monthly median costs for a semiprivate room vary from $5,639 in Texas to $31,282 in Alaska.

What Questions Should You Ask During Facility Visits?

Never make a nursing home decision without visiting facilities in person. Plan to tour at least three to five communities before making your final choice. Bring a detailed checklist to ensure you evaluate each facility consistently.

During your visit, observe staff interactions with residents. Are staff members friendly, polite, and respectful? Do they address residents by name? The quality of these interactions often reveals more about a facility than any brochure or website. Request information about staff-to-resident ratios and ask what happens when additional care providers are needed during emergencies or high-demand periods.

Examine the physical environment thoroughly. Walk through resident rooms, bathrooms, dining areas, and common spaces. A quality nursing home maintains cleanliness in corners, kitchens, nurses' stations, and all public areas. Unpleasant odors may indicate problems with basic care standards. Verify that the facility has adequate lighting, comfortable temperatures, and clear hallways free from obstacles that could cause falls.

Schedule a second unannounced visit at a different time of day and day of the week. This approach allows you to meet different staff members and observe various activities and meal services. If possible, arrive during mealtime to assess food quality and the dining atmosphere. Many facilities allow visitors to sample meals, providing valuable insight into daily life for residents.

What Certifications and Accreditations Matter?

Verify that any nursing home you consider holds proper Medicare and Medicaid certification. These certifications ensure the facility meets federal health and safety standards. Beyond basic certification, look for additional accreditations from organizations like the Joint Commission or the Commission on Accreditation of Rehabilitation Facilities. These voluntary accreditations demonstrate a commitment to exceeding minimum standards.

Review recent inspection reports through Medicare's website or request copies directly from the facility. Pay attention to any violations cited and how quickly the facility corrected identified issues. All nursing homes must undergo regular state and federal inspections, and these reports provide objective data about facility performance.

What Services and Amenities Should the Facility Offer?

Comprehensive nursing homes provide more than basic medical care. Evaluate the range of services available, including physical therapy, occupational therapy, speech therapy, and specialized memory care programs. If your loved one has specific health conditions like dementia or requires dialysis, confirm the facility has appropriate programming and trained staff.

Social activities and enrichment programs significantly impact resident wellbeing. Quality facilities offer diverse activities including exercise classes, crafts, social events, and opportunities for community engagement. These programs help residents maintain cognitive function and emotional health while building connections with fellow residents.

Ask about access to additional medical services such as dental care, podiatry, optometry, and pain management. Many facilities maintain relationships with specialists who visit regularly or can see residents as needed. Clarify how the nursing home handles emergency medical situations and which nearby hospitals they partner with for acute care needs.

How Do You Navigate Payment Options?

Understanding payment mechanisms prevents financial surprises down the road. Medicare covers limited short-term nursing home care following a three-day hospitalization, but does not pay for long-term custodial care. Many families initially pay out of pocket until their savings are depleted, then transition to Medicaid coverage.

Medicaid pays for care for approximately 70 percent of nursing home residents. However, eligibility depends on income and asset levels, which vary by state. Consult with an elder law attorney before spending significant savings, as proper planning can help protect family assets while ensuring access to necessary care.

Long-term care insurance may cover some or all nursing home costs depending on policy terms. Review your policy carefully or consult with the insurance provider to understand coverage limits, waiting periods, and any restrictions on facilities or care types.

What Resident Rights Should You Understand?

Federal law guarantees specific rights to all nursing home residents. These include the right to participate in care planning decisions, access medical records, voice grievances without retaliation, and receive visitors during reasonable hours. Residents maintain the right to manage their own finances unless a guardian has been appointed.

Every certified nursing home must have a Resident Council and welcome family participation in a Family Council. These groups provide forums for addressing concerns, suggesting improvements, and building community among residents and their families. Ask whether the facility's council meeting minutes are available for review before admission.

Understanding complaint and dispute resolution processes proves essential. Identify who to contact if problems arise, both within the facility and through external channels like the state ombudsman program. The National Institute on Aging provides resources for families navigating long-term care decisions.

Making an Informed Nursing Home Decision

Choosing a nursing home requires careful research, multiple facility visits, and honest assessment of care needs and financial resources. Focus on facilities that demonstrate strong staff-to-resident ratios, maintain high cleanliness standards, offer comprehensive services, and show evidence of respectful care through staff interactions with residents. Compare quality ratings, review inspection reports, and trust your instincts about the overall environment and culture. Taking time to thoroughly evaluate options helps ensure your loved one receives quality care in a setting that supports their dignity, health, and quality of life.