7 Red Flags To Look For When Evaluating A Nursing Home

Photo of author
Written By Charlotte Miller

Choosing a nursing home for a loved one is an incredibly difficult and emotional decision. As places that are supposed to provide dedicated care and service to elders, nursing homes are sacred. Unfortunately, many nursing homes fall short of providing the compassionate care they advertise. Research suggests that about 10% of all nursing home residents experience [a]some form of abuse or neglect.

This prevalence of abuse means you cannot simply overlook things or assume all is well when picking a home for your loved one. You must be vigilant and look for any red flags that could compromise your loved one’s safety and well-being. Being informed and proactive will help ensure you find a facility you can trust completely with your loved one’s care.

Below are seven major red flags to be aware of when assessing a potential nursing home.

1. Poor Reputation

Do online research and talk to people in the community. Complaints and negative reviews can highlight serious issues, and a nursing home with a poor reputation likely earned it.

Search online reviews and talk to hospital discharge planners, local senior groups, and others who may have insight. Numerous complaints about poor care, neglect, abuse, understaffing, or other problems should raise red flags. If you come across multiple accounts of abuse or neglect, consulting with a nursing home abuse lawyer might be a prudent step to better understand residents’ rights and how to address potential legal concerns. Facilities earn bad reputations for a reason, so do not ignore consistent negative feedback.

While no nursing home is perfect, one with a poor reputation in the community suggests deeper issues. Complaints of abuse, neglect, understaffing, and health violations indicate risk to your loved one’s well-being. A few negative reviews may be unavoidable, but patterns reveal systemic problems. Carefully weigh reputation along with your own observations when evaluating facilities.

2. Insufficient Staffing  

Ask about staff-to-resident ratios and look for signs of understaffing, like call bells going unanswered or rushed, impersonal care. If a facility is understaffed, residents may not get the individualized time and attention they need.

Along with staff-to-resident ratios, observe how staff interact with residents. Do they seem rushed? Impatient? Short-tempered? Are residents left waiting for long periods? Understaffing often results in staff frustration and inability to provide adequate care.

Residents may be left in soiled clothing or bedding, increasing infection risk and taking away their dignity. Their needs may go unmet, resulting in dehydration, malnutrition, bedsores, and other problems.

Therefore, sufficient staffing levels are essential. When there are enough staff members, they have enough time to assist with activities of daily living in an unhurried, compassionate manner.

3. Lack of Activities

Ask to see an activities calendar. Residents should have access to a variety of stimulating and engaging activities tailored to their interests and abilities. A lack of organized activities is a red flag. It can lead to boredom and isolation, which negatively impact mental and physical health.

Beyond scheduled activities, look for evidence that residents have opportunities to participate in hobbies, socialize, and remain mentally active. Talk to residents to get a sense of how they spend their time. Do they highlight favorite activities? Appear bored or lonely? Quality of life requires more than just television. Activities should stimulate the mind and body according to each resident’s abilities.

Social interaction is also critical. Creative activities and community involvement prevent isolation and depression. Therefore, an engaging, well-rounded activities program is a must.

4. Restricted Visitation  

A good nursing home encourages visitors and doesn’t unreasonably limit visiting hours. Restricted visitation hinders family involvement and oversight and can also indicate that the facility has something to hide. Pay attention to visitation policies – hours, limits on number of visitors, and access to residents’ rooms. While some restrictions may be reasonable, excessive limits are a red flag.

Residents’ rooms should be considered private spaces they can use to visit loved ones. Quality facilities encourage family involvement and make visitors feel welcome. If you find restrictions in certain places, make sure to ask the facility why they exist. Inflexible policies that isolate residents from visitors signal problems.

5. Poor Cleanliness and Sanitation

Check if the nursing home seems dirty or unkempt. Before you admit your loved one here, look for things like foul odors, visible dirt and dust, unclean bedding, and residents who appear unbathed and ungroomed. Poor sanitation increases the risk of infection and demonstrates a lack of attention to residents’ dignity and comfort.  

A quality nursing home will be visibly clean and tidy. Make sure to check all areas for cleanliness – not just public spaces but also residents’ rooms, bathrooms, and care areas. Dirt, grime, and clutter can accumulate quickly in corners and crevices, so inspect them carefully. Don’t just glance; look under beds, open closets, check baseboards and ceilings. Any unpleasant odors could signal a problem.

Also, ensure bed linens are clean, changed regularly, and intact – not ripped or stained. Notice residents’ hygiene as well. Are their clothes clean? Fingernails trimmed? Do they seem freshly bathed?

6. Resistance to Questions

Observe how staff react to questions and requests to see areas like the kitchen, laundry, and bathing rooms. Do they dodge questions or rush you along? Limit areas you can enter? Discourage talking to residents? Staff should welcome questions and allow you to tour freely and speak with residents. Defensiveness and evasiveness suggest the facility has something to hide.

A quality nursing home should be open to any question and give you free access to all areas used by residents. The staff should facilitate conversations with residents to get their unfiltered perspectives. You should be able to speak with nurses, aides, therapists, the activities director, and the administrator. Secrecy or barriers to open communication are red flags.

7. Lack of Individualized Care Plans

Ask to see records of comprehensive assessments and individualized care plans for residents, which should be done for each new admission. Care plans should be based on thorough assessments of each resident’s medical conditions, capabilities, interests, and preferences. They outline goals and detail specific care approaches for that individual. Without individualized plans, residents get generic, impersonal care that does not meet their needs.

Look for evidence of customized plans that address both medical and lifestyle considerations. These include diagnoses, mobility level, dietary needs, medications, but also interests, hobbies, sleep habits, and emotional needs. Staff should be familiar with each resident’s care plan. Lack of plans tailored to each resident’s needs or reliance on a generic one-size-fits-all approach could be an indicator of neglect.


Choosing a nursing home is difficult, but being vigilant protects those you love. Watch for these red flags, trust your instincts, and keep looking until you find a facility you are completely confident in. The right nursing home becomes like a family for residents. Never settle for less than outstanding care. Be proactive and speak up at the first sign of any issues. Though they may not emotionally care for your loved one the same way that you do, the least you should expect is the same level of physical care.


Categories Law