Some additional items to consider:
1. Check out the government websites of nursing homes, including the '5 Star ranking' score
of the ones you are considering. As you narrow down your choices you
may want to look into the factors behind the rankings. The site allows you to do that.
Remember that the rankings are averages of some specific factors not during inspections, and don't include second-hand reports such as patient satisfaction surveys. On the other hand, be aware that some places put special effort into 'passing the inspection'. But consistently high ranking may be a good starting place. I have found that it often matches my own experiences with the facilities.
2. Have a look at the list of USNews 'Honor Roll' nursing homes. Also, watch for other articles and news reports that identify recognized model facilities, like Miami Jewish Health Systems and Hebrew Home of Riverdale. Many of these rankings start with the government 5-star
ranking mentioned in #1, and have the same limitations as
the ranking itself. Even if you don't select one of these nursing
homes, just visiting them probably gives you a good reference for
3. See what the CNA's who are providing the care are saying, in their own forums.
While they won't name employer names, you can get an idea of their
issues and frustrations. Try to get an idea if the concerns you read
about on-line, like inadequate coverage and unrealistic expectations,
might be concerns in the places you visit. Ask about, or observe, how many patients each CNA is responsible for (their coverage ratio).
4. Learn the signs. Before visiting any home, take just a little time to learn some of the tell-tale signs of quality care. Also, as suggested in the original post above, trust your nose.
You won't always find bad news, by the way.
5. Check out Elder Abuse Attorney websites,
and avoid any nursing home owned by companies with frequent problems in
their other facilities. You may have to do some research, because
ownership of facilities owned by large chains is sometimes not clear. One large national chain that has been repeatedly cited by elder attorneys and the AARP operates
under many different local names. My own opinion of their facilities that I have experience with matches matches AARP's.
6. For-profit or non-profit? While this is not a critical factor in itself, you might check to see
if the nursing home is for-profit or non-profit. For-profit isn't bad, but just in general you should be aware of the facility's status. On average, non-profits have paid their staff a bit more, though that certainly varies by facility.
7. Check references, as you would with any care provider. Besides families, professional care managers can be a help. Also, many states have ombudsmen that look into complaints about nursing homes. For example, Florida has regional ombudsmen
who take consumer complaints. While they usually get involved after
there is a problem, it may be worthwhile to check with them during the
8. Follow-up with an independent observer. Once you or your loved ones make your selection, consider having your
own private CNA, RN, or care manager visit. Ideally, it should be
someone who is able to identify possible problems,
signs of infection or developing sores, as well as observe
general conditions and care. Even with regular visits by family
members, you will want to verify that all is really well. It doesn't have to be expensive. In most areas, highly experienced, qualified private-duty CNA's will do this for a nominal amout ($15 or $20 for the hour).
Lastly, Medicare has an on-line pamphlet, and also a checklist.