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Nursing Homes & Long-Term Care

How to Choose a Nursing Home: 2026 Complete Guide

NHQC Editorial Team · Last updated April 14, 2026

Medicare's Care Compare tool publishes the CMS Five-Star Quality Rating for every certified nursing home. Filter by ZIP, then sort by Overall Rating. Focus on 4- and 5-star facilities with strong Staffing sub-ratings — staffing correlates more tightly with resident outcomes than any other measure.

Each facility's Form 2567 lists every deficiency cited in the most recent state survey, including severity (scope & severity grid A–L). Repeat citations or grade-G+ harm findings are red flags.

Visit once during a weekday meal (observe dining, odors, call-light response) and once on a weekend (staffing is typically lightest). Bring the visit checklist.

  • What is your nurse-to-resident ratio on day / evening / night shifts?
  • What is annual staff turnover?
  • How are care plan meetings scheduled, and may family attend?
  • What is your policy on antipsychotic medications for dementia?

Confirm whether the facility accepts Medicaid (for long-term stays) and its Medicare certification status. Ask for the Resident Agreement and read the discharge/transfer policy before signing.

Disclaimer: This content is for educational purposes only and is not medical, legal, or financial advice. NHQualityCampaign.org is not affiliated with or endorsed by the U.S. government or the federal Medicare program.

Frequently Asked Questions

What is the single best indicator of nursing home quality?+
Registered-nurse staffing hours per resident per day. Research consistently links higher RN staffing to lower hospitalization, pressure ulcer, and mortality rates.
Should I rule out a 3-star facility?+
Not automatically. Read the inspection report — the quality of problems matters more than the count.
How much does a nursing home cost?+
The US median is about $9,000/month for a semi-private room (Genworth 2023 Cost of Care Survey), highly variable by state.
Who pays for nursing home care?+
Medicaid covers long-term care for those who qualify; Medicare only covers short-term skilled care post-hospitalization.
Can a nursing home evict a resident?+
Only under six specific federal grounds, with 30-day notice and appeal rights.

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