How to choose a skilled nursing facility

Start with the star ratings, but read them right

Every Medicare-certified facility carries a federal rating of one to five stars, and it is the single most reliable public quality signal - every listing on Find Their Care shows it. The overall star is built from three parts, and the parts matter more than the average:

• Health inspections: results of unannounced state surveys, including complaints. The hardest to game and the one to weight most.
• Staffing: nursing hours per resident per day. Staffing is the strongest everyday predictor of the experience your parent will actually have.
• Quality measures: self-reported clinical outcomes (falls, pressure ulcers, rehospitalizations). Useful, but self-reported.
• A practical bar: treat the overall star as a screen, then look at the staffing star specifically. A 4-star facility with 2-star staffing deserves questions.

Questions worth asking on the tour

Skip the marketing script and ask operational questions - the answers tell you how the building really runs:

• How many residents does each nurse and each aide care for, on days and on nights?
• Is there a physician or nurse practitioner in the building, and how often?
• How often will my parent get therapy, and for how many minutes a session?
• How do you communicate with families - and how fast do you return calls? (On Find Their Care, verified facilities answer messages through the platform, and response speed is something we track.)
• What happens when Medicare coverage ends - what is the private rate and can residents transition to Medicaid in place?
• Can I see this week's activities calendar and today's menu?

Trust your senses

In twenty minutes of walking a building, your senses collect more truth than an hour of presentations. Notice: does it smell clean (not masked)? Are residents up, dressed, and engaged, or parked in hallways? Do staff greet residents by name? Do call lights get answered while you watch? Visit at an unglamorous hour if you can - late afternoon and mealtimes show a facility as it is.

Red flags

None of these alone is disqualifying, but each deserves a direct question, and two or three together are an answer:

• Evasive answers about staffing numbers or a refusal to share inspection results (facilities must make survey results available).
• A one-star health inspection rating, or repeated serious deficiencies across surveys.
• Pressure to sign admission paperwork on the spot, or a request that you personally guarantee payment.
• Persistent odors, unanswered call lights, or residents who appear unattended for long stretches.
• No clear answer to "who do I call when something goes wrong, and when do they call me back?"

Use the tools on this site

Find Their Care exists to compress this exact process. Search your area, filter by the care you need, and every listing carries the official CMS ratings. Save the candidates and use the compare view to see them side by side - including distance from your home and from the hospital. Facilities marked Verified are run by operators who actively manage their listing, show live availability, and answer family messages directly on the platform, so you can start the conversation before you ever pick up the phone.

More guides

• What is skilled nursing care?
• How skilled nursing care gets paid for
• What to expect when your parent is admitted