Tips on picking a nursing home for a loved one

Research, visit, make a care plan, be an advocate

Pressley Henningsen, attorney at RSH Legal in Cedar Rapids. (20190 photo)
Pressley Henningsen, attorney at RSH Legal in Cedar Rapids. (20190 photo)

Pressley Henningsen

Becoming a resident at a nursing home is frightening, stressful and often sad for both the elderly person entering the home and for their family members.

Many issues are at play — emotional, financial, guilt, practicalities and so on.

One primary question that warrants early consideration in this process is safety. Specifically, you might wonder: “How do I keep my loved one safe in a nursing home?” 

Many factors are involved, but let me share just three important tips to help you answer this question.


There are good nursing homes. There are good staff in every nursing home. But not every home is the right fit for your family member.

You should do a very thorough review of the home on the internet.

Two online sources you must consider are the Iowa Department of Inspections and Appeals-Health Facilities Division website, where you want to do an “Entity Search.” Specifically search for all entities you are considering and read the last few year’s reports and citations.

You will get a feel for the safety record of the home by doing so.

Also, make sure you ask all potential homes how many aides are on each shift and how many residents each aide is expected to take care of at one time. Iowa does not require a certain number of aides, but, I assure you, the more, the better. How can an aide properly supervise seven to 10 (or more) residents at one time?

Also consider location and how often you will be able to visit a certain home. A home on your way to and from work will be easy to drop in on.

And you must drop in, unannounced, and at different times as often as you can because you want to see the care that is being given when the nursing home does not know you are going to be there.

Before making a decision on a home, stop by at least a couple of times. One time can be a scheduled meeting. On the other visit, just stop by unannounced and get a feel for the place.

Care plan

Make your own care plan. All Medicare-certified nursing homes must assess each resident and make an individualized care plan to meet the needs of each resident. 

You should, too. You know your loved one better than anyone. You should list what you consider to be the needs of your family member and think about what you would put in place to meet those needs.

After reviewing and editing your plan, provide it to the nursing home. Ask if the nursing home is going to meet the needs you identified.

You do not need to think of every medical condition or risk here — that is the nursing home’s job — but you can help supplement any care plan they come up with the unique requirements only you could know.

For example, you might know that your mom requires a cup of coffee alone in the morning for her own peace of mind before she gets up for breakfast with everyone else. If you don’t share this with the home, they won’t know, and if you do not share it in writing, the staff is likely going to forget such details.

As your loved one ages, make sure you update your care plan and provide it to the home. 


Always be an advocate.

Sometimes family members are nervous about making complaints or raising safety concerns if nothing “bad” has happened yet. They are worried if they complain their loved one might face consequences.

But you must do so because prevention is the No. 1 safety rule in nursing homes.

You want to attend the care planning sessions but also write reasonable, levelheaded concerns to the nursing home’s administrator and director of nursing any time you see issues arise. It is their job to address your concerns.

Keep your emotions in check — even if you are upset — and always keep a copy of all communications. The goal is get your loved one the care they need, not engage in an argument.

Start the process of finding the right home as early as you can. It takes time.

It is an honor to take care of the elderly, and your role as researcher, team member, and advocate is an important role they cannot live without.

• Pressley Henningsen is an attorney at RSH Legal in Cedar Rapids. “Legal Matters” appears monthly.

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