Provides information to help individuals, family members, caregivers, and those who assist them find and compare nursing homes, and make informed decisions about nursing home care

The “Guide to Choosing a Nursing Home” is designed to help you make informed decisions about nursing home care, whether you’re planning ahead or need to make an unexpected decision. Choosing a nursing home can be very stressful for you and your loved ones.

It is helpful to plan ahead, consider all your long-term care options, and make good financial plans early. Planning ahead gives you and your family more control. It can help make sure that your needs are met so you can get good quality care.

Before You Get Started
You may have other long-term care options like community services, home care, or assisted living depending on your needs and resources. Before choosing a nursing home, see if one of these other choices might be better for you, or if they might help after a short nursing home stay. These and other long-term care choices are explained briefly on pages 11–16.

If You Are Helping Another Person
Helping another person choose a nursing home or make other long-term care choices can be difficult. Your support is important and can help your loved one adjust to getting new services or living in a new setting like a nursing home. Be sure to include the person you are helping when making decisions whenever possible. Always make decisions with their needs and preferences in mind.

Download Guide to Choosing a Nursing Home

PDF format, 951KB, 68Pages.

The “Guide to Choosing a Nursing Home” is prepared by the Centers for Medicare & Medicaid Services (CMS). CMS and states oversee the quality of nursing homes. State and Federal government agencies certify nursing homes to participate in Medicare and Medicaid.

This official government booklet explains:

• How to find and compare nursing homes
• How to pay for nursing home care
• Your nursing home resident rights
• Where to call for help

WORDS TO KNOW
Custodial Care—Nonskilled personal care, such as help with activities of daily living like bathing, dressing, eating, getting in or out of a bed or chair, moving around, and using the bathroom. It may also include the kind of health-related care that most people do themselves, like using eye drops. In most cases, Medicare doesn’t pay for custodial care.

End-Stage Renal Disease (ESRD)—Permanent kidney failure that requires a regular course of dialysis or a kidney transplant.

Long-Term Care Ombudsman—An independent advocate (supporter) for nursing home and assisted living facility residents who works to solve problems between residents and nursing homes or assisted living facilities. They may be able to provide information about home health agencies in their area.

Medicaid—A joint Federal and state program that helps with medical costs for some people with limited income and resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Medicare—The Federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Medicare Advantage Plan (Part C)—A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you are enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Health Plan—A Medicare health plan is offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan.

Medicare Prescription Drug Plan (Part D)—A stand-alone drug plan that adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Original Medicare—Original Medicare is fee-for-service coverage under which the government pays your health care providers directly for your Part A and/or Part B benefits.

Skilled Nursing Facility (SNF)—A nursing facility with the staff and equipment to give skilled nursing care and, in most cases, skilled rehabilitative services and other related health services.

Skilled Nursing Facility Care—Skilled nursing care and rehabilitation services provided on a continuous, daily basis, in a skilled nursing facility.

State Health Insurance Assistance Program (SHIP)—A state program that gets money from the Federal government to give free local health insurance counseling to people with Medicare.

State Medical Assistance (Medicaid) Office—A state agency that is in charge of the state’s Medicaid program and can give information about programs to help pay medical bills for people with limited income and resources.

State Survey Agency—A state agency that oversees health care facilities that participate in the Medicare and/or Medicaid programs. The State Survey Agency inspects health care facilities and investigates complaints to ensure that health and safety standards are met.

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