You'd never choose a new house without visiting and inspecting it. Yet too often families do just that for a nursing home. A typical scenario: A fall sends Mom to the hospital, and you've got a day or two to find a home prior to her discharge.
Care in nursing homes can range from excellent to downright abusive, so it's worth following this plan to create a short list of the best options in your area ahead of time.
Look at the official stats. You can use Medicare's nursing home ratings as a starting point for your search. Just don't take the star ratings as gospel, says Jocelyn Montgomery of the California Association of Health Facilities.
Instead, click on "health inspections" and "staffing" to drill down on the details. For example, are citations due to medication errors (beware), or failing to create a care plan (less harmful)? Check how much time each resident gets with nurses: the more hours, the better.
Next, click on the "state survey agency" link to get the contact information for your state's ombudsman and licensing agency; they can tell you about consumer complaints.
Finally, call to make sure a given facility has a unit dedicated to your parent's specific issue (such as dementia).
Visit more than once. No matter how stellar the ratings, a visit is critical. Do an official tour and ask how personal preferences are accommodated (can Mom decide when to shower?) and whether staff work with the same patients each day.
"When staffers know the patients better, quality of care is higher," says Cheryl Phillips, a geriatric physician and senior advocate at the nonprofit LeadingAge.
Observe lifestyle details: If Mom is bedridden, will she be helped to activities? Do nurses greet patients in the hall? Do they eat in a dining room or in bed? If you don't need to place your parent immediately, also drop by unannounced on a weekend, when staffing is likely to be tighter.
Determine who will pay. Recently the median price of nursing homes topped $190 a day ($70,500 a year). Medicare, the senior insurance program, will only partly cover the tab for up to 100 days after a hospital stay.
If Dad has long-term-care insurance, find out the daily rate it covers (which may be far less than the cost of your preferred homes), and don't count on using it from the get-go—most policies kick in only after an "elimination period" of 60 or 90 days.
Once Dad's resources are running low, he can qualify for Medicaid, the government program for low-income individuals (rules vary by state), so make sure your preferred facilities accept Medicaid (not all do) and find out if he'll have to move when he switches payment.
Finally, keep in mind that the best homes often have waiting lists, so if you know your parent will need care, get him on the list ASAP.