10 Questions to Ask When Touring a Nursing Home

Touring a nursing home can be emotional and overwhelming. You are there because someone you love needs care, and the pressure to make the right choice is real. Having a clear set of questions prepared before you walk in helps you stay focused, compare facilities objectively, and notice things you might otherwise miss.

These ten questions are designed to give you a thorough picture of how a facility operates day to day — beyond what the brochure shows you.

1. What is the staff-to-resident ratio on each shift?

Staffing is one of the strongest predictors of care quality. Ask specifically about the ratio of certified nursing assistants (CNAs) to residents during the day shift, evening shift, and overnight shift. Staffing tends to be thinnest on nights and weekends, so don't just ask about the best-case scenario.

CMS publishes staffing data for every certified nursing home, and you can see it on CareNav under the staffing rating for each facility. But the published data is averaged — the on-the-ground reality during off-peak hours is what matters for your loved one's daily experience.

2. How do you handle medical emergencies?

Ask what happens when a resident has a fall, a sudden change in condition, or a medical emergency in the middle of the night. Is there a registered nurse on site 24 hours a day, or only during certain shifts? What is the relationship with the nearest hospital? How quickly can emergency transport arrive?

The answer to this question tells you a lot about the facility's infrastructure and preparedness. A well-run facility will have clear protocols and will describe them confidently.

3. Who is the medical director, and how often are residents seen by a physician?

Every nursing home is required to have a medical director, but the level of physician involvement varies widely. Some facilities have physicians on site multiple days per week. Others rely on the medical director visiting periodically, with nurse practitioners or physician assistants handling day-to-day medical decisions.

Ask how often your loved one would be seen by a doctor, how you would be notified about changes in their medical status, and what the process is for updating the care plan.

4. What does a typical day look like for residents?

This question gets at the quality of life beyond medical care. Ask about the daily schedule — meals, activities, therapy sessions, social programs, and free time. Are residents encouraged to participate in activities, or is the programming optional and underattended?

Look at the activity calendar if one is posted. A robust, varied schedule suggests that the facility invests in residents' well-being beyond basic medical needs. Ask specifically about programming for residents with cognitive impairment, as their needs are different from those of residents who are cognitively intact.

5. Can I see the kitchen and a sample menu?

Nutrition matters enormously in a nursing home setting. Ask to see the kitchen (a reputable facility will have no problem with this) and look at a sample weekly menu. Ask whether meals are prepared on site or delivered from an outside provider. Ask about dietary accommodations — can the kitchen handle diabetic diets, pureed diets, low-sodium diets, kosher or halal meals, and food allergies?

During your tour, if mealtime is happening, observe. Are residents eating in a communal dining room or alone in their rooms? Is the atmosphere pleasant? Is staff available to assist residents who need help eating?

6. What is your approach to managing pain and medications?

Pain management is a critical aspect of nursing home care, particularly for residents with chronic conditions. Ask how pain is assessed and managed, how medication changes are communicated to families, and what the facility's approach is to the use of psychotropic medications (sedatives, antipsychotics, antidepressants).

The use of psychotropic medications in nursing homes is closely monitored by CMS. Facilities that rely heavily on these medications to manage behavior rather than investing in non-pharmacological approaches may have quality concerns worth investigating.

7. How do you communicate with families?

Clear, proactive communication between the facility and the family is one of the strongest indicators of a well-managed nursing home. Ask how and how often you will be updated about your loved one's condition. Is there a family portal? A primary point of contact? Regular care conferences?

Ask what happens if your loved one has a fall or a significant change in condition — how quickly will you be notified, and by whom? The best facilities have structured communication protocols that keep families informed without families having to chase information.

8. What are the visiting hours and policies?

Visiting policies vary significantly between facilities. Some have fully open visiting hours, while others restrict visits to certain times of day. Ask whether there are restrictions on the number of visitors, whether children are welcome, and whether there is a comfortable space for families to visit.

Since the pandemic, many families are particularly sensitive to visiting policies. Ask whether the facility has any remaining restrictions and how they would handle future outbreaks or public health situations.

9. How do you handle complaints and grievances?

Every nursing home is required to have a grievance process, but the quality and responsiveness of that process varies. Ask who handles complaints, what the typical response time is, and whether you can see the facility's most recent state inspection report (which documents any cited deficiencies).

A facility that is transparent about its grievance process and inspection history is generally one that takes quality seriously. If the staff becomes evasive when you ask about complaints or inspections, that is a red flag.

10. What happens if my loved one's needs change?

Care needs evolve over time. Ask what happens if your loved one's condition improves (can they transition to a lower level of care within the facility?) or worsens (does the facility have the capacity to handle increased medical needs, or would a transfer be necessary?). If your loved one has early-stage dementia, ask whether the facility has a dedicated memory care unit and at what point a resident would be transitioned into it.

Understanding the facility's ability to adapt to changing needs helps you avoid a situation where your loved one has to be moved to a different facility during a vulnerable time.

Before and after the tour

Before your tour, review the facility's CMS ratings and family reviews on CareNav. This gives you baseline context so you know what to look for during your visit. After the tour, write down your impressions while they are fresh. If you are comparing multiple facilities, a simple scorecard based on these ten questions can help you make a structured comparison.

Finding the right nursing home takes time and effort, but asking the right questions puts you in a much stronger position to make the best choice for your family.