Choosing the Right Facility

With so many different elder care facilities available, it is sometimes difficult to know which one to choose and why.  The reality is, however, that choosing the right facility with the care and community that’s both a good fit for your loved one and matches well with your own unique circumstances can often be the most important decision you will make.  Many times, it is necessary to balance the strengths and weaknesses of each potential location to determine which facility is best for your family’s particular needs and desires. 

By “doing your homework” prior to placing a family member in a nursing home or assisted living facility (ALF), you can drastically reduce the probability that problems will arise.  InjuryBoard has compiled information from numerous sources and created this article to provide you with the best information on how to choose a facility that’s right for you. 

Research Several Facilities Before Committing To One

When working to prevent negative outcomes for senior citizens, it is essential that you select a facility that is right for you and your family member.  The prospect of leaving a loved one in someone else’s care can be unsettling and there are many elements to consider when choosing a facility, but with some research and a general understanding of what to look for, you can take the right steps to ensure that your loved one receives proper care. 

Consider the Facility's Reputation

Understanding the history of the nursing home or ALF your considering can is the first step in choosing a facility.  Here are some practical ways to help you research a facility’s reputation. 

Ask Family and Friends -- Ask family and friends if they know or have heard anything about the facilities that you’re considering. 

Send out an Email – By asking your questions by email, you get a chance to learn more not just from your circle of relationships but also their network of friends, families, and co-workers, as well.  Be sure to ask them to “forward your mail” to others on your behalf. 

Do Some Detective Work – The internet is a great place to find out if a facility is frequently committing violations.  Needless to say, if a potential facility experiences recurrent citations for violations, it is advisable to omit that facility from your pool of possibilities. 

Dig Deeper – Most state agencies that oversee health care facilities have extensive websites devoted to keeping you informed and up to date on government actions or consumer complaints. 

In Florida, for example, The Agency for Health Care Administration publishes a yearly report ranking several factors critical to the smooth and safe operation of facilities.  Facilities are required to make this survey available to the public.  This survey uses a scale of one to five stars to grade nursing homes and ALFs on categories such as dignity, quality of care, and administration. 

The report ranks each element individually, so families can focus only on facilities earning high marks in the categories most important to the family.  For example, if a family views efficient administration is an important characteristic of a good facility, they can use the report to narrow their choices down to only facilities with high marks in administration.  This makes the survey a valuable tool in determining which facility is right for your loved one’s specific needs. 

Remember, however, that although some facilities are safer than others, no nursing home or ALF is perfect.  Some minor problems will be present even in the best facilities.  The important point is to find a safe and people-oriented facility that’s right for your loved one. 

Here are some good resources for helping you dig deeper and find out more about the facilities in your area. 

  • CLICK HERE - to view nursing home violations by state, please visit
  • CLICK HERE - for more information about nursing home inspections and criteria
  • CLICK HERE - for a list of Medicare nursing homes on the internet

KEY STRATEGY – Make researching a facility’s reputation by asking family, friends, co-workers, and their friends as well as getting information from government agencies your first step in finding the right facility.

Make Unannounced Visits at Different Times of the Day

A crucial element in evaluating a facility is actually visiting the facility, personally.  To get the best picture of what that facility will be like when your loved one lives there, you should visit several times, unannounced, and at different times of the day.   During your visit, you will still have to be escorted by a facility representative, but by being spontaneous and unpredictable with your timing, you are more likely to witness the actual day-to-day operations of the facility, rather than the “cleaned up” version you might experience if the facility staff is expecting you. 

An unannounced visit means the staff has little time to do any “special” cleaning or hide imperfections in their operations and procedures.  During your visit, take note of your surroundings and ask yourself these and other key questions: 

  • Does the facility have a foul odor? 
  • How many staff members are on duty? 
  • Do the current residents seem satisfied and relatively healthy? 
  • Are there enough staff that speaks your (and the patient’s) language? 
  • Are there spills and/or safety hazards in the area? 
  • Are immobile residents in wheelchairs left unattended? 
  • How is the attitude and demeanor of each staff member?  

In making these assessments, you will gain an accurate perspective of what life will be like for your family member if he or she were to live at the facility. 

  • CLICK HERE - for more information on how to select an ALF or nursing home
  • CLICK HERE - for a checklist to bring with you during your visit

KEY STRATEGY – Make several unscheduled and unpredictable visits to a faciilty and look closely at the state of the facility and its residents.

Find Facilities That Cater To Your Specialized Needs

Many different types of professionals work in nursing homes and ALFs to ensure the comfort, safety, and progress of senior citizens and facilities today can offer a vast array of services.  It may be helpful to take into account whether the specific needs of your loved one will be met by the types of services each facility offers. 

For example, nursing homes often offer specialized care for people with Alzheimer’s disease, diabetes, dementia, HIV or AIDS, respiratory trouble, Huntington’s disease, physical disabilities, mental disorders, and other ailments.  If your loved one requires special care, it is a good idea to investigate facilities that offer units dedicated to exceptional care. 

Likewise, once you have located a facility that offers the type of care you desire, it is also important to survey the staff.  For example, if a senior citizen has suffered a stroke and requires speech therapy, then ask questions and make sure the facility is staffed with a speech therapist.  If a facility claims to offer specialized care, then it should be staffed accordingly. 

  • CLICK HERE - for additional strategies and nursing home guidance

KEY STRATEGY – Consider the individualized needs of your loved one and choose a facility that has adequate staff and facilities to cater to those specific needs.

Location, Location, Location

Finally, location is an extremely important and often overlooked factor in deciding which facility would best serve your family.  While a facility’s reputation, upkeep and staff are some of the most important factors in a family’s decision, location can actually help you make your final decision. 

Generally speaking, the closer the facility, the more frequent the visits you’re likely to make.  Personal visits and close communication with your loved one as well as the relationships you develop with staff and healthcare professionals are the best ways to monitor your family member and keep them safe.  Because of these factors, some families may choose a nearby facility with less of a reputation rather than a distant facility with an impeccable reputation. 

The key to remember here, is that the more times a patient is visited the less likely it is that the patient will be abused. 

For more information on local information, referral resources, and contact information for state and local agencies, check out the ElderCare Locator from the United States' Health and Human Services Department.   

KEY STRATEGY – Choosing a facility close to family and friends offers a variety of benefits, including lower likelihood of abuse due to more frequent visits.  In the event that the older adult is abused, the violation is more likely to be discovered in time to get help.

Read the next article: Safety and Preventing Abuse and Neglect 

Contact an attorney in your area.