10 Questions to Ask During a Tour

What's the nurse-to-resident ratio?

Low staffing is the #1 problem in nursing homes. Ask how many residents each CNA (nursing assistant) cares for during the day, evening, and night shifts. Fewer than 10 residents per CNA is ideal.

How often does staff turn over?

High turnover means inconsistent care and inexperienced staff. Ask what their turnover rate is. Less than 30% annually is good; over 50% is a red flag.

Are there RNs on-site 24/7?

Federal law requires an RN on duty 8 hours a day, but 24/7 is better. Ask if there's always an RN in the building, especially at night.

Who will be my main point of contact?

Find out who coordinates care and who you should call with questions or concerns.

What's your star rating and why?

Ask them to explain their Medicare star rating (you can check it yourself at Medicare.gov). If it's low, ask what they're doing to improve.

What were your last inspection issues?

Every facility has deficiencies. Ask what the most recent problems were and how they fixed them. Honesty is a good sign.

How do you prevent falls and bedsores?

These are common problems. Ask what protocols they have in place and what their rates are.

How do you handle complaints?

Ask about their grievance process. Do they have a resident/family council? How quickly do they respond to concerns?

What does a typical day look like?

Ask for a schedule. When are meals? Activities? How much time do residents spend just sitting around?

What activities do you offer?

Look for variety—exercise, games, music, outings, pet therapy. Ask how often residents actually participate.

Can I see the dining room during a meal?

Visit during lunch or dinner. Is the food decent? Are residents being helped if they need it? Is it noisy or calm?

How do you handle special diets?

Ask if they can accommodate dietary restrictions, food preferences, or cultural foods.

What's the total monthly cost?

Get a written breakdown of all costs—base rate, medications, therapy, supplies, and any extra fees.

Do you accept Medicaid?

If yes, ask: Do I have to pay privately first? How long? What happens if I run out of money? Are there limited Medicaid beds?

What's your discharge policy?

Ask what happens if you can't pay anymore or if they decide the facility isn't a good fit. Can they force you to leave?

Is there a waiting list?

Ask how long it typically takes to get a bed.

Who provides medical care?

Does the facility have doctors on staff, or do residents keep their own doctors? How often do doctors visit?

What happens in an emergency?

Ask about their protocol for falls, sudden illness, or medical crises. Do they call 911 or handle it in-house?

How do you handle medications?

Who manages meds? How do you prevent errors? What if a resident refuses medication?

Do you have memory care or hospice services?

If your loved one has dementia or might need end-of-life care, ask if the facility provides specialized care.

What are visiting hours?

Are families welcome anytime, or are there restrictions? Can you visit during meals or care times?

Can I take my loved one out for the day?

Ask about day passes or overnight visits home. Some facilities make it difficult.

How do you communicate with families?

Will they call you with updates? How often? Can you access medical records or care plans?

Is there a family council?

Family councils give families a voice in the facility's operations. If there isn't one, that's a yellow flag.

Does it smell clean?

A little smell is normal, but if it reeks of urine or is overpowering, that's a bad sign.

Do residents look well-cared-for?

Are they clean, dressed, and groomed? Or are they in bed in the middle of the day or sitting alone in hallways?

How does the staff interact with residents?

Are they kind, patient, and respectful? Do they make eye contact and talk TO residents (not about them)?

Are call lights being answered?

If you hear call lights going off repeatedly without staff responding, that's a red flag for understaffing.