7 Must-Know Signs of a Good Nursing Home [Expert Review]

Looking to know the signs of a good nursing home? Then, look no further. As someone with decades in the industry, here are the 7 must-know tips to help you!

There are many factors to consider when looking for a nursing home. Based on my experience, here are some of the most important things to consider.

CMS Star Rating

To start, you’ll want to begin by doing your research. Head to Medicare.gov and search for the skilled nursing facility or assisted living of your choice. Look at the overall star rating, health inspection rating, quality measures, staffing rating, health inspection rating, and specifics such as RN rating (based on the number of RNs working versus LPNs or LVNs). The more stars the better! Five stars are the top overall rating for nursing homes and assisted living centers.

Pro Tip: It takes months to years to sometimes affect certain metrics with the star rating. Therefore, it’s not a current picture of the facility, but rather it gives you a good long-term perspective.


You may ask how is location one of the signs of a good nursing home?

Location is a very important factor when considering a nursing home. It should be decided in advance how far you would be willing to drive back and forth to visit loved ones. For example, if 20 miles is too far to drive on a regular basis, then maybe you should limit your search to nursing homes nearby. If the distance is not a factor, this may open up more options when deciding on a facility.

Back to why location is one of the signs of a good nursing home – because you can tell a lot by how it looks and where it’s located in the city.

One of my favorite things to do is to drive to the back of the parking lot – ideally behind the nursing home. You can tell a lot by how they care for it. Is there garbage everywhere? Is the landscape overgrown? Does it look clean or dirty from the outside?

Signs of a Good Nursing Home Environment:

  • Clean & Neat
  • Welcoming During (Daytime & Afterhours)
  • Helpful and Caring Staff
  • Good Staffing Ratio (Number of Staff to Residents)

Pro Tip: Don’t call in advance to arrange a tour of the nursing home. Make an impromptu visit during off hours when the Admissions Department isn’t there. Look to see what occurs during off hours. You can always come back during the day for a polished experience.

Nursing Home Environment

When it comes to the environment, first and foremost, it must pass the sniff test. Yes, I said it! Silly as it is, it should not have a stench. Nursing home residents should be toileted frequently and trash should be taken out. An ideal center should be close to odor-free from contaminants in most areas of the facility.

Home-Like Decor

The environmental decor is another factor to think about when choosing a facility. Studies have shown that hospital-like nursing homes can lead to increased depression in residents.

For example, grayish-colored walls and limited decorations may make it difficult for new residents to adjust because the environment is distinctly different from their previous living situation.

Simple decorations, greenery, and a home-like setting can really add a lot to an environment. If you choose a hospital-like environment it is recommended to surround the new resident with their belongings (i.e. pictures or other objects of importance). This could significantly improve adjustment to the nursing home setting.

Regulation Challenges

Nursing homes remain among the most highly regulated industries in the United States. Often times this is why centers avoid changing the decor, which could give them a national or state deficiency citation.

I remember years ago when one of my colleagues went to a store and bought a bunch of new bedspreads for her resident’s rooms. She wanted them to have something new and more colorful. However, she didn’t realize at the time the items were not flame retardant and would not meet the required guidelines. She ended up having to return them all. But the company assisted her with purchasing bedspreads that met the code requirements and had a bit more color.

While regulations are necessary to keep loved ones safe, they can restrict making quick changes. However, when done well, creating a home-like environment can make all the difference to residents.

Nursing Home Staff Make the Difference

The staff at nursing homes can make a monumental impact on the residents’ quality of life. Staff members who are willing to put in an individualized effort to assist residents in making a difference from those who consider their position “just another job.”

Passionate staff members will not only take care of your loved one but also may be more enthusiastic in providing their services. Because they provide such excellent services, these people are considered indispensable.

Another one of the signs of a good nursing home is staff with longevity. If you see a lot of agency staff with very few permanent staff, there is high turnover. Turnover can lead to an increased risk of medical errors.

Activities & Things to Do

Activities make up a large portion of the day at nursing homes. For this reason, it is important that you or your loved one chooses a facility that has activities of interest. While the majority of nursing homes have the basic types of activities (i.e. bingo), many also have a variety of other types of activities available.

When visiting a nursing home, ask for a calendar of events to find out what activities will be offered on what days. Even though a facility may not list activities of interest, one should always ask because sometimes needs can be accommodated.

Food & Nutrition

signs of a good nursing home
Food Quality: One of the Signs of a Good Nursing Home

From my experience, food tops the list of complaints by residents at nursing homes. Mostly, this is because the food comes at least three times a day. Since residents look forward to meals, it can be disappointing when it doesn’t turn out the way they had imagined.

But honestly, Food and Nutrition Service often gets a bad rap. No matter how good the cooks are, it isn’t quite the same as a home-cooked meal. When you are cooking for a hundred or more people, not everyone is going to like it the same way. While one may love it, the other person may find the food too bland.

Some facilities, especially assisted living facilities, offer potential residents an opportunity to sample the food beforehand. This is a good way to see if your loved one likes the food, and if substitutes are available when they don’t like what is offered. While some facilities may give limited options, others may be willing to work with specific preferences (such as cultural foods not ordinarily on the menu).

Ask Around

Bad customer service or poor care travels like wildfire in most communities. Check out Google reviews, Yelp reviews, and even the NextDoor App. There are plenty of other places where people like to voice their concerns related to nursing home care.

You can also get a lot of good information as well from your primary care doctor, who may have a facility they see patients at.

Keep in mind, a lot occurs in a nursing home over a few months with staff turnover, so don’t focus too much on things that happened years ago.

Final Thoughts: Signs of a Good Nursing Home

I hope this article provided some helpful information to you in your search for a quality facility. The signs of a good nursing home, in some ways, remind me of how I judge a restaurant. I won’t eat at a place with a filthy kitchen or disgusting restrooms. The same type of concept.

However, all this adds up to one main question. Where would your loved one be happiest at? If you keep focused on that, you’ll know your answer.