The Quick Tip List was developed to give an overall indication of what to look for when touring the nursing home by looking at just 5 categories of questions. The questions are easy to understand, common sense things to look for when touring a facility. Just use your senses (Look, Listen, Smell and Taste) for each category of questions and you will be able to determine whether a facility has high standards. Higher standards are the key to better the care. Don’t accept explanations or excuses from the nursing home you are considering. If you find a nursing home with low standards, move on to the next nursing facility.

1. Facility

Look for cleanliness and be aware of any strong odors. 

  • Look at the floors – Are they shiny if tiled, and are they free from stains, if carpeted?
  • Look at the furniture – Is it dirty and worn?
  • Look at the structure – Are the walls, doors and fixtures in good repair?
  • Is the home well lit? Are there any strong foul odors?
  • Are there overpowering “good smelling” fragrances that could be masking or covering up foul odors.

2. Staff

Look & listen to observe the following:

  • Is the staff well-groomed and dressed professionally and appropriately?
  • How does the staff interact with patients and visitors?
  • Does staff seem friendly, caring, patient, polite and helpful?
  • Do they seem happy?
  • Does the care staff seem to work well with each other?
  • Is staff polite and courteous or are they complaining to each other?
  • Is the interaction between management and the care staff positive?
  • When you ask questions, does management seem forthcoming or are they hesitant to answer? Do they seem agitated or aggravated?

3. Patients

Look, listen, & smell to observe the following:

Note: Do not go into any patient’s room without the expressed permission of the patient and the staff. Please respect the privacy of the patients. Are the patients that you see groomed and clean? (shaven, nails trimmed and dressed appropriately)

  • Do you smell any strong odors coming from the patients?
  • Do patients seem to be receiving attention by staff if needed?
  • Are the patients that are more active and social involved in any activities?
  • Do they seem to be enjoying their interaction with staff?

4. Dining & Food

Look, listen, smell and taste to observe what is going on in the dining room and kitchen.

Tour the nursing home during meal time and ask if you may dine. Look for food choices. Look at and listen to how the staff interacts with the patients during meal time. Food is one of the most important aspects of patient satisfaction. Look for a nursing home that treats this standard very seriously.

  • Is the food attractively served?
  • Is the food served at an appropriate temperature?
  • Is the food tasty?
  • Do residents seem to like the food being served?
  • Is there enough staff to assist patients who need help eating?
  • Ask if you can see the kitchen and talk to the dietitian.
  • Do they seem to be enjoying their interaction with staff?

5. Care

Care standards should be evaluated as it relates to both skilled care services and custodial care services.

-Skilled Care Services

Medicare has come up with a tool to help people to determine whether a nursing home is providing quality care to patients. The Medicare Nursing Home Compare website found HERE has a Five Star Rating System on nursing home care that contains quality of resident care and staffing information for more than 15,000 nursing homes around the country.

Here are a few ways you can evaluate the facility’s standards for skilled care while you are on your tour.

  • Does the nursing home have a current license?
  • Does the administrator have a current license?
  • Is the nursing home Medicare-Medicaid certified?
  • What is the RN/LPN to patient ratio for day, evening and night?
  • What is the nurse aide to patient ratio for day, evening and night?
  • Are there onsite therapy programs where patients are receiving therapy?
  • Does the nursing home have special programs where staff have been specifically trained to take care of such care issues as Alzheimer’s or wound care?
  • Do you see any evidence of such programs and care taking place?

-Custodial Care Services

Custodial care can be determined by evaluating the Activities of Daily Living (ADLs) of those who need care. It is easier to evaluate whether the care is being administered and administered properly because we, as lay people, can see, hear and smell the results or the lack of results of the caregiver’s actions in personal care services. ADLs Include Assistance with:

  • Bathing
  • Dressing
  • Grooming
  • Eating
  • Ambulation
  • Transferring
  • Toileting
  • Hygiene
  • Walking & other similar tasks
  • Supervision & help with medications
Sage Aging ElderCare Guide
Author: Sage Aging ElderCare Guide

Sage Aging ElderCare Guide was created to lead families to good information on senior living and care choices. You will find educational articles, videos, podcasts, worksheets and searchable provider directories on this website to help you make quality decisions. Feel free to contact us at or call us at 863-802-5043 if you need additional assistance.