How to Choose a Skilled Nursing Facility

When it comes time to choose a skilled nursing center for you or a loved one, whether it is for short stay rehabilitation or long-term care, you might feel overwhelmed by all the options available. When making a decision about what center is right for you, remember, each short-stay patient or long-term resident - young, older, bedridden, or disabled - has different needs, preferences, and desires that should be taken into account in the selection of a center. At a minimum, you should consider the following when making your decision:

Care Services

Every skilled nursing center offers different levels of care in varying environments. Some facilities focus purely on long-term care residents while others are more geared toward post-hospital, short stay care, and some cater to both. When deciding whether a center can meet your particular needs, ask the following questions:

  • Based on my condition, do I need short stay rehabilitation or longer-term care?
  • What is your percent of long-term care vs. short-stay rehabilitation patients?
  • Is the center focused on getting you home as quickly and safely as possible?
  • Does your center offer any specialty care programs or enhanced clinical capabilities?'
  • Can you provide me with physician coverage if my doctor cannot follow my care at your center?
  • Will I require physical, occupational and/or speech therapy and does the center offer these services? Be sure to tour the therapy gym, especially if you will need rehab before returning home.
  • Some centers use advanced technologies like the Wii gaming system, Vital Stim, E-stim. Be sure to ask what types of rehab equipment will be used in your care.
  • Are patients, residents and families encouraged to participate in developing a care plan?
  • Are other medical professionals (dentists, podiatrists, optometrists) available to me?
  • How are prescriptions drugs ordered and administered?

Licensure and Certification

While you can probably assume a skilled nursing center has all the appropriate licensure and certifications, you should make sure.

  • Is the center licensed in the state?
  • Is the center duly certified to provide Medicare and Medicaid coverage?
  • Is the center's latest state survey report available for review?
  • Does the center have a formal quality assurance program?
  • Has the center received any awards or additional certifications that make the Center stand out?


Just as care varies by center so do the amenities. Some centers are 30 or 40 years old and haven't changed since that time while others have been fully renovated and have new technologies and upgrades. Consider the following questions, particularly if you cannot tour the center in advance:

  • How old is your building and when is the last time it has been renovated?
  • Try to locate pictures of the center online to see if the atmosphere is welcoming and attractive.
  • Do you have private and semi-private rooms available?
  • Are private telephone lines and TVs provided? Are they free of charge?
  • Do you have free Internet access and/ or wireless connectivity?
  • Are private areas available for me and my family to meet outside of my room?
  • Ask for a sample menu and gauge your ability to choose your own meals.
  • Does the center have always available meal options or snacks?
  • Do I have the ability to make special dining or menu requests?


It is important to inquire about required training and qualifications, in addition to the community's general philosophy. Visiting the center and personally observing the interactions between staff and patients or residents is also a great way to judge your compatibility with the center. You can also ask the following:

  • How many Attending Physicians/Nurse Practitioners are on staff and will they be involved in my care?
  • How many RNs are on staff and what is the staffing ratio per patient/resident?
  • Do therapists-- physical, occupational, recreation and speech pathologists—work on staff? How many days per week?

Cost and fees

While you may not have a choice about needing skilled nursing care, understanding cost and whether you will be covered by Medicare, Medicaid or private insurance is important. If not, you will need to pay for your care out of pocket. Any center should be able to assess your financial situation and determine your eligibility. In addition, be sure to inquire about hidden fees that you may be responsible for including TV, phone, transportation, beauty/barber, or other types of services.

Family Members

If you are helping a loved one to select center, you should involve that person in the process when they are able. Because at the end of the day, you want to make sure they are in a location where they feel comfortable. By planning ahead, you can ensure that your loved one will be provided with the highest quality of care and quality of life.

So when choosing a skilled nursing center, consider all the options. Written materials or websites can be useful tools for comparing centers. When able, touring the facility and asking questions is the best way to determine a good fit, but phone interviews using the guide above can also be effective. In the end, by researching and reviewing all aspects of the care and services, your success in recovery or transition to long-term care will be much easier.