10 Steps for Picking the Right Nursing Home

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As Wilmington NC nursing home abuse and neglect lawyers, we have seen terrible instances of abuse and neglect occur at nursing home facilities.  Putting a parent or other loved in a nursing home is a difficult and financially costly decision.  It is important to pick the right facility.  First and foremost, you want to ensure your loved one is receiving exceptional care.  Here are some steps we advise our clients take when selecting a facility for their loved one. 

  1. Discuss the transition with your family.

This is a difficult decision, and sometimes, can result in disagreements. If possible, make sure to involve the person actually going into the new home.  Many times, we see adult children make decisions without involving their parents, this often leads to problems.  In many instances, it’s absolutely clear that the person requires around-the-clock care. If nobody can render the care your loved one needs, then it’s time to start looking at available options. 

  1. Ask your doctor.

You, or your loved one’s, primary care doctor will have a very good sense if it’s time to consider a nursing home facility. Your doctor can also probably offer some recommendations.  Ask your doctor what level of care he or she believes is necessary, this will help you begin searching for the best suited facility. 

  1. Find nursing homes in your area. 

After consulting with your doctor, you will need to decide what level of care is necessary.  Does your loved one need help bathing, eating, and conducting other daily activities?  These are issues you, and your loved one must consider.  Make sure everybody understands the level of care necessary.  Once you’ve determined the level of care necessary, follow these basic steps to get the search started: 

  • Ask people you trust.  Family, friends, co-workers, or neighbors can be good referral sources.  
  • Ask your doctor, or any other doctors you know, whether they provide care at any nursing homes in the area.  If so, they may be able to identify certain facilities to avoid. 
  • Contact your local senior resource center.  If you live in Wilmington, NC, contact the New Hanover County Resource center here. https://src.nhcgov.com/
  • If you’re at the hospital, ask a social worker about discharge planning as early in the stay as possible. The hospital staff should be able to help arrange placement in a suitable facility upon discharge. 


  1. Do some simple online research. 

Federal, state, and local agencies have made it easy for consumers to conduct in-depth research into nursing homes.  Nursing homes are highly regulated by the government, and they undergo routine inspections.  In North Carolina, complaints, inspection results, and other important information is available online.  Follow these steps below to research potential facilities online:


  1. Visit at least three facilities. 

Select some of the nursing homes from your research and schedule visits to the facility.  If possible, visit several facilities so that you can compare them for yourself.  Don’t be afraid to ask questions or interact with staff at the facility.  If a resident is willing, ask them about their experience.  Observe how the staff seem to interact with the residents.  After your scheduled visit, try to drop by unannounced several days later to see the facility again.  

  1. Choose the best facility. 

Trust your senses.  What facility’s staff seemed to treat the residents with compassion, dignity, and respect?  What facility seemed to highly value cleanliness and fostered an environment where residents could engage in select social, religious, recreational, and cultural activities?  Did it appear to be a well-managed facility? 

These are some of the questions you should ask yourself when selecting the best facility.  If you have narrowed down your options, it may be worth asking the facility if you or your loved one can join the other residents for a meal. Spending an evening at the facility may help you determine if it’s a good fit, or not. 

  1. Make arrangements to be admitted. 

Once you have selected the facility best suited to care for your loved one, you will need to begin making arrangements for admission.  Make sure you have found and provided the following information: 

  • Insurance information: this includes the name of the insurance company and the policy number.  If Medicare or Medicaid is covering the costs, then the facility cannot require you to pay a cash deposit.  The facility can also not allow you to pay more than the rates permitted by Medicare or Medicaid. 
  • Medical history: your doctors should be able to provide this information.  This includes any prior health problems, surgeries, chronic conditions, allergies, and vaccinations.
  • Prescription medications: make sure to provide a list of any medications you’re currently prescribed, include the dose, how often you take it, when you take it, and why you take it. 
  • A list of your healthcare providers: just because somebody is moving to a long term care facility does not mean they’re changing doctors.  Make sure the facility is known by healthcare providers in case they are needed. 
  • A list of family members: include their full name, address, email address, and phone numbers.


  1. Visit loved ones often, unannounced, and at different times.

If your loved one is an assisted living facility, make sure somebody is visiting as regularly as possible.  Many facilities know when the residents are going to receive visitors.  Try to visit unannounced and at different times so that you can get an accurate picture of what’s going on each day.  Try to develop relationships with some of the staff members; a friend may be more willing to tell you if something is wrong. 

  1. Remain vigilant 

Your loved one may be unable, or unwilling, to report any abuse or neglect to you.  Many elderly residents have memory impairments, or they’re too proud to file a complaint.  Look out for some of these common signs of abuse and neglect. 

  • Pressure ulcers/sores
  • Dehydration
  • Malnutrition
  • Overuse or illegal use of physical restraints
  • Medication overdosing or under-dosing
  • Theft
  • Financial exploitation
  • Physical or sexual assault
  • Battery
  • Neglect
  • Unclean/unsanitary living conditions 
  • Falls 
  • Unexplained injuries 
  • Sudden change in behavior 
  • Wandering/leaving the facility unsupervised 
  • Rapid weight loss 


  1. Raise any concerns immediately 

If you have any concerns about your loved one, no matter how big or small, immediately report them to management. There should be documentation of the complaint, and you should continue to follow up.  The main priority is to make sure any concern is quickly addressed.  If the issue is so egregious, or is not being addressed, then contact your local Department of Social Services and file a complaint.  The Department will conduct an investigation into the issue.  If you believe your loved one is in danger, then make all efforts to move them out of the facility.  

If you believe your loved one has suffered from nursing home abuse and/or neglect contact the Wilmington NC nursing home abuse attorneys at Horton & Mendez for a free confidential consultation. We take protecting our elderly population very seriously, and will fight tirelessly to hold accountable nursing homes in the wrong.

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