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Choosing a Quality Nursing Home for Your Loved Ones

Picking a nursing home is a stressful and emotional process. Its important when deciding on a facility to pick one that is a safe and nurturing environment. Illinois has the second highest number of poorly ranked nursing homes in the country behind Indiana. Elder abuse and neglect is a rampant problem in nursing homes across the country. People in homes are susceptible to abuse physically, emotionally, and even financially. Furthermore negligent care can have serious health consequences for residents who are managing illnesses. The Centers for Medicare and Medicaid Services ranks nursing homes on a scale of one to five stars. Their data can be looked up at under the nursing home compare link. Additionally, call an ombudsman to find out about any specific complaints registered about that nursing home. (find local ombudsman here. These are both good resources to use when researching a facility, but personally investigating the nursing home is vital to making a final decision.

Visiting the Facility

When choosing a home, its important to be proactive! Make sure to visit the home separately at day and night to see the full range of care provided. When visiting prospective nursing homes, ask to meet with the executive director, lead physician, and head nurse. If they avoid speaking with you, that could be a bad sign. Another good idea is to attend a resident or family council meeting to learn more about the home and the cycle of care it provides. If possible, find homes that practice person-centered care. This allows residents to make their own schedules for sleeping, eating, and other activities, giving the resident more freedom. Its also a good idea to find out if they have consistent assignment, meaning that patients interact exclusively with the same staff on a daily basis. Having consistent relationships helps improve the residents quality of life.

Red Flags

High Staff Turnover

What is the percentage of staff turnover each year? Over 30% turnover may indicate a problem.


What does it smell like when you enter the home? A stench of urine could indicate low quality care. The smell of cleaning solution also may not mean the facility is clean but some other smell is being covered up.


Look out for restraint devices on wheelchairs, beds, and/or chairs.


Are residents allowed a choice for their meals? Are they allowed snacks in between meals if they get hungry? Are those who cant feed themselves being assisted?

Staff interaction with residents

Watch out for any rude or disrespectful behavior from staff members towards residents. This could be indicative of elder abuse. Any shouting by staff members is inappropriate and evidence of a high stress environment.

Resident behavior and appearance

Pay attention to the disposition of residents and whether or not they look depressed. Activities should be available for those who want to participate.

Privacy and Security

Access to different parts of the facility shouldnt be too freely granted or too restricted.


There should not be dirty linens or unstored linens in the hallways. Residents should always receive medications on schedule and staff should wait to make sure they are fully swallowed.

Elder Abuse

Abusive caregivers will often try to mask the signs of abuse by chalking them up to dementia or illness. Unexplained injuries, bruises, welts, scars, broken bones, sprains, dislocations, incorrect dosing of medication can be signs of physical abuse. Emotional abuse can be detected by observing threatening or belittling behavior by staff or behaviors such as rocking back and forth, sucking, or mumbling to oneself. Signs of neglect can be weight loss, malnutrition, dehydration, bed sores, or dirty bedding. Any combination of these signs is an indication to look elsewhere for the care of your loved ones.