Nursing Home Care
You can check all the star ratings you want, but nothing beats walking through a facility and using your eyes (and nose).
Here's what to look for—and what should make you turn around and leave.
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Let's start with the obvious one: if it smells like urine or feces, run.
A faint medical smell? Normal. A slight odor in one room because someone just had an accident? Fine. But if the whole place reeks, that means:
What you might smell:
Trust your nose. If it smells bad, care is bad.
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Look at the people living there. Really look.
Red flags:
If residents look like no one's taking care of them, it's because no one is.
What good care looks like:
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Walk down the hallways. What do you see?
If there are rows of people in wheelchairs facing the walls, staring at nothing, doing nothing—that's not okay.
Why this happens:
What you want to see:
Boredom and isolation are forms of neglect.
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Pay attention to how staff act when you walk in.
Red flags:
Good signs:
Happy staff = better care. Miserable staff = high turnover and neglect.
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If the tour feels rushed, if they won't let you see certain areas, or if they say "that wing is closed right now"—be suspicious.
What they might be hiding:
What you should be able to see:
If they won't show you something, assume it's bad.
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It's 2 PM on a Tuesday. Are most people in bed?
Unless they're sick or it's designated "quiet time," residents should be up, dressed, and out of bed during the day.
Why this is a red flag:
People shouldn't be warehoused in bed all day. That's not living—that's existing.
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Ask to see the dining room during mealtime.
Red flags:
Good signs:
If the food is terrible, residents won't eat. And if they don't eat, they decline fast.
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Ask the staff member giving the tour:
Red flags:
If staff don't know basic information about how the facility operates, something's wrong.
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Before you tour, check the facility's inspection report on Medicare.gov/care-compare.
Look for violations related to:
One or two minor violations? Normal. But repeated serious violations mean the facility doesn't care about fixing problems.
Ask about violations during the tour. See how they respond. Do they own up to it and explain what they've changed? Or do they get defensive and make excuses?
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This one's intangible, but it matters.
If you walk in and feel uncomfortable, uneasy, or like something's just "off"—trust that feeling.
Maybe you can't pinpoint exactly what's wrong. Maybe everything looks okay on paper. But if your instinct is screaming "no," listen to it.
You know what a caring environment feels like. You know what respect and dignity look like. If you're not seeing it, keep looking.
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During the tour:
After the tour:
If you see serious issues:
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Star ratings are helpful, but they don't tell you what it actually feels like to be there.
Use your eyes. Use your nose. Use your gut.
If a place feels wrong, it probably is. Keep looking.
Your loved one deserves better.
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