How to Choose a Nursing Home

Hospice & Senior Care Finder · Published October 27, 2026

If you're choosing a nursing home for a parent or partner, you may have only a few days, often with a hospital discharge date already set. Medicare's advice comes in four steps: research the homes in your area, compare their quality, visit them (or have someone visit for you), then choose the one that best meets the person's needs. This guide follows those steps and shows where to find each piece of information, including on our listings, which come from CMS data as of September 1, 2026.

If the person is in the hospital now, ask the hospital social worker about discharge planning as early as you can. And if you're not sure a nursing home is the right level of care, read our comparison of nursing homes and assisted living first.

Start with a shortlist

Ask people you trust about homes they know, and ask whether your doctor works at any nursing homes nearby. The Eldercare Locator, a public service of the federal Administration for Community Living, has information on nursing home choices in your area. You can call or text trained staff at 1-800-677-1116.

Then look the homes up. Our state pages list nursing homes city by city. We add states in weekly batches, so if yours isn't listed yet, use Medicare's Care Compare, where you can put up to three homes side by side.

Every home on Care Compare, and every home we list, is certified by Medicare, Medicaid or both. That matters. "Certified" means the home passed an inspection by a state government agency, and Medicare and Medicaid only pay for care in certified homes.

Read each listing section by section

Medicare suggests comparing three things: health inspection results, staffing, and quality measures. Our listings show those, plus penalties and any CMS warning flags. Here's what to look at in each part.

Star ratings

Look at all four ratings, not just the overall star. The overall rating is mostly the inspection rating, moved up or down by staffing and quality, so a middle score can hide one strong area and one weak one. Inspection stars are also graded against other homes in the same state. Our guide to what CMS star ratings mean explains how they're built.

Inspections

Check the date of the most recent standard inspection first. These inspections are unannounced and happen about once a year on average. Across all homes in the CMS file, 6.7% carry the CMS flag that the latest standard inspection is more than two years old, and our listings show a notice when that applies.

Then compare the number of deficiencies with the state average shown next to it. A count tells you how many problems were cited, not what they were. Care Compare has the older inspection reports if you want to read what the inspectors actually found.

Staffing

Our listings show reported nurse hours per resident per day next to state and U.S. averages, along with registered nurse hours, weekend hours and staff turnover. In our analysis of CMS data as of September 1, 2026, the median home reported 3.68 total nurse hours per resident per day, and 3.26 on weekends. Median nursing staff turnover was 44.9%.

If a home's weekend hours are well below its overall figure, or its turnover is well above the state average, write it down. You'll want to ask about it.

Penalties and warning flags

In the CMS file, 44.3% of all nursing homes had at least one fine. Among those, the median total was $33,594. A fine on its own doesn't rule a home out, but ask what it was for and what changed afterward.

The abuse icon means CMS cited the home for issues related to abuse. In our analysis, 9.7% of homes carried it. Medicare's checklist suggests asking any home whether it has been cited for abuse in the last year or two.

If a home is a Special Focus Facility, it has a history of serious quality issues and isn't star-rated. CMS suggests visiting, asking what the home is doing to improve, calling the state survey agency and the State Ombudsman, and checking how long the home has been in the program.

Ownership

Each listing shows the ownership type and any affiliated group. In our analysis, 74% of nursing homes are for-profit and 69.3% belong to a chain or affiliated group. On Care Compare you can open performance information for the affiliated group and see ownership details, including the owners' names. That's useful if you want to know how the group's other homes do.

Call before you go

A phone call can narrow the list before you spend an afternoon on a visit. Ask whether there's a bed available, and whether the home accepts Medicare, Medicaid or both. If you'll be paying privately for any stretch, ask for a list of what the private-pay rate includes and what's charged separately. Certified homes must give you information about their services, charges and fees in writing.

Ask about staffing in their own words: how many staff are assigned per resident during the day, overnight and on weekends, and how many residents each nurse aide is responsible for on average. Ask what happens in a medical emergency. If your parent or partner has dementia, ask whether there's a dedicated dementia care unit and how the home avoids antipsychotic drugs whenever possible.

Visit with the Medicare checklist

Print Medicare's Nursing Home Checklist (form CMS-12130) and take a fresh copy to each home. If you can't go yourself, ask someone you trust to go for you.

While you're there, talk to residents and their families if you can. Watch for staff who are slow to respond, strong odors, residents calling out, and safety risks such as residents walking around unsupervised. Ask to see the most recent inspection report. The home has to keep it in a public place.

Bring your notes from the listing. If the page showed high turnover, a recent fine or the abuse icon, ask about that specific item and listen to how they answer.

Talk to your state's long-term care ombudsman

Every state has an Office of the State Long-Term Care Ombudsman, led by a full-time State Ombudsman. Its representatives identify, investigate and resolve complaints made by or for residents of long-term care facilities. Medicare suggests contacting your state's office as part of the decision, along with Care Compare, visits, conversations with residents and their visitors, and talking with your doctor or a social worker.

If you don't know how to reach your state's office, call or text the Eldercare Locator at 1-800-677-1116 and ask.

If the first choice doesn't work out

You aren't locked in. If your parent or partner moves into a nursing home and it isn't right, they can move to another facility that has a bed available. They may need to give notice first, and not following the home's rules can mean extra fees, so ask about the notice policy before you sign.