Although there may be pressure to choose a nursing home quickly because of government regulations or changing health care needs, you are strongly urged to tour the facilities under consideration before making your final selection.

Before you visit, call the admissions department to make an appointment and make sure you have completed the necessary forms. Many facilities, for example, require that the PRI and Screen be completed before the application is considered and you are allowed to visit.

During your visit, try to speak to anyone and everyone who can give you information family members, residents, nurses and aides, and so on in order to develop as full a picture as possible of the day-to-day operation of the facility.

It may be useful to focus on the following 10 aspects of a nursing home when you visit:

Medical Services - How many physicians are on staff? Are residents assigned a physician upon admission to the facility? What is the procedure if you wish to choose your own physician? To which hospitals are residents transferred in case of emergency?

Nursing - Are residents grouped according to nursing needs? Is staff coverage adequate on evenings and weekends?

Therapy - What kinds of therapy are available--for example, physical, occupational, and speech? Is there a special room set aside for physical therapy or occupational therapy? If so, ask when it is used and look for residents receiving or waiting to receive treatment.

Recreational Activities - Are residents actively engaged in activities during your visit? Ask for a copy of the activities calendar, which should also be posted for residents' review. What are the special programs offered for residents with special needs, such as those who are blind or deaf? Are residents able to get out into the community for shopping and other activities? Is transportation provided? When does the residents' council, which looks into residents' problems and complaints, meet? Are family members welcome at meetings? What are the in-room activities for bed-bound residents? How do bed-bound residents participate in unit activities?

Volunteer Services - Does the nursing home encourage the involvement of volunteers from the community? What types of services do they provide?

Social Services/Admissions - Who coordinates admissions? Are short stays accepted? How are the rooms assigned? Is there an orientation program for new residents and/or families? How do residents obtain individual counseling or participate in group programs? Is there a family council that provides support to families and reviews problems in the home? What are the visiting hours?

Resident Profile - Is the atmosphere of the nursing home institutional or homelike? Are there personal belongings in residents' rooms such as quilts, plants, and photographs? Are the residents dressed, well groomed, and out of bed? Is there interaction between staff and residents? Do the staff address residents by name?

Food - Stay for a meal and observe. Is the food hot? Does it look appetizing? Are special diets respected? Are residents assisted in eating? By whom? Do the staff talk to residents during meals? Does anyone notice if a resident does not eat?

Physical Plant - Is the building clean and well maintained? What are the security provisions? Is the entire home air-conditioned in summer and heated in winter? Is it odor-free? Is there any evidence of insects or rodents? Do secure railings line the walls?

Location/Size - Is the home large or small, and would that make a difference to the resident? Is the nursing home located near any family or friends? Is it accessible by public transportation? Are there shops or other facilities nearby?

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