Modern medicine has given many of our parents longer lives than their own parents had, along with years of recovery after strokes, falls, and surgeries that once would have ended them. That said, those added years sometimes arrive at a point where a parent needs more care than a family can safely give at home.
When that moment comes, it often comes fast — a hospital discharge planner asks for a facility name by Friday, and the family has never set foot in a nursing home. We understand how disorienting that is, and this guide lays out a search process that works on a short timeline as well as a long one.
To find a nursing home for a parent, search Medicare Care Compare by ZIP code, shortlist Medicaid-certified homes near family, read recent inspection reports, tour at different hours, and get the Medicaid bed policy in writing.
Step One: Confirm the Level of Care Your Parent Actually Needs
Before comparing facilities, it helps to know which kind of facility you are comparing. A nursing home (formally a skilled nursing facility, or SNF, when Medicare certified) provides 24-hour nursing supervision, while assisted living and memory care offer help with daily activities but usually far less clinical care.
The deciding factor is typically your parent's need for help with activities of daily living (ADLs) such as bathing, dressing, transferring, toileting, and eating, plus any skilled needs like wound care or IV medication. Our guide to the nursing home level of care assessment explains how states score those needs, which also governs Medicaid eligibility for nursing home coverage.
Keep in mind that short-term rehab and long-term custodial care are often delivered in the same building but paid for very differently. Medicare can cover up to 100 days of skilled care per benefit period after a qualifying inpatient hospital stay, but it does not pay for long-term custodial care.
Medicare covers skilled nursing care for up to 100 days per benefit period after a qualifying three-day inpatient stay. Long-term custodial care is paid privately, by long-term care insurance, or by Medicaid.
If your parent is in the hospital now, check whether they were admitted as an inpatient or kept "under observation," because observation days do not count toward the three-day requirement. The three-midnight rule explainer walks through how to ask the hospital that question.
Step Two: Build a Shortlist on Medicare Care Compare
Medicare Care Compare (medicare.gov/care-compare) is the federal database of every nursing home that participates in Medicare or Medicaid. Enter a ZIP code or city, select "Nursing homes including rehab services," and the tool returns facilities sorted by distance, each with an overall star rating from one to five.
Distance matters more than many families expect. Frequent visits from relatives are one of the most reliable ways to notice changes in a parent's care, so many families draw a radius of 20 to 30 minutes from the person who will visit most and treat anything outside it as a fallback.
Next, narrow the list with the filters and profile details Care Compare provides. Here is what to check on each facility's page before it earns a spot on your shortlist:
- Program participation. The profile states whether the home participates in Medicare, Medicaid, or both. If a parent may ever need Medicaid, a home that participates in both is generally the safer choice.
- Ownership. Care Compare lists the ownership type and links to ownership details. Recent ownership changes are worth asking about, since staffing and policies can shift after a sale.
- Special designations. Look for the Special Focus Facility marker and the red abuse icon, both explained below. Either one deserves a direct conversation with the administrator, not automatic dismissal.
- Specialty units. If your parent has dementia, confirm whether the home has a secured memory care unit, since not every facility does.
A shortlist of four to six homes is usually manageable on a crisis timeline. Remember that the hospital discharge planner is required to give you a list of available facilities and respect your choice, so you are not obligated to accept the first bed offered.
How to Read Care Compare Star Ratings
The overall star rating is a composite of three separate ratings, and the components often tell a more useful story than the headline number. CMS builds the overall rating from the health inspection rating, then adjusts it up or down based on staffing and quality measures.
| Rating | What it measures | Where the data comes from | What to watch for |
|---|---|---|---|
| Health inspections | Number, scope, and severity of deficiencies found by state surveyors | Standard annual surveys and complaint investigations | Ranked relative to other homes in the same state, so a four-star home in one state is not directly comparable to one in another |
| Staffing | Nurse and aide hours per resident per day, RN hours, weekend staffing, and turnover | Payroll-Based Journal data submitted by the facility | Low weekend staffing and high RN turnover are frequent sources of family complaints |
| Quality measures | Outcomes such as falls with major injury, pressure ulcers, antipsychotic use, and rehospitalization | Resident assessments and Medicare claims | Short-stay and long-stay measures are separate — use the one that matches your parent's situation |
For instance, a home with a strong overall rating but one star for staffing may look fine on paper yet struggle on nights and weekends. On the contrary, a three-star home with clean recent inspections and stable staffing can be a better fit than its headline number suggests.
Care Compare's overall star rating combines health inspections, staffing, and quality measures. Health inspection stars are ranked within each state, so compare homes in the same state and read each component.
How to Read State Inspection Reports
Every certified nursing home is inspected by its state survey agency on behalf of CMS, generally about once a year and no less than every 15 months on a statewide average. The findings are recorded on Form CMS-2567, the Statement of Deficiencies and Plan of Correction, which you can open from the "View all health inspections" link on Care Compare.
Each deficiency (called an "F-tag") is assigned a letter from A to L on a scope-and-severity grid. The letter tells you how serious the problem was and how widespread, which matters far more than the raw count of citations.
| Letters | Severity level | What it means for a family |
|---|---|---|
| A–C | No actual harm, minimal potential for harm | Usually paperwork or minor process issues |
| D–F | No actual harm, potential for more than minimal harm | The most common range; read the narrative to judge relevance to your parent |
| G–I | Actual harm that is not immediate jeopardy | A resident was hurt; ask what changed afterward |
| J–L | Immediate jeopardy to resident health or safety | The most serious findings; ask for the plan of correction and the follow-up survey result |
When reading a report, focus on the narrative under each citation rather than the regulatory language. A citation for an unlabeled food container and a citation for a resident who developed a stage 4 pressure ulcer may carry the same F-tag category but tell very different stories.
Look for patterns across years, too. A repeated citation for falls, medication errors, or infection control suggests a systemic problem, while a single isolated finding that was corrected and not repeated is less concerning.
State inspection findings appear on Form CMS-2567, graded A to L for scope and severity. Letters G through I mean a resident was harmed; J through L mean immediate jeopardy to health or safety.
Special Focus Facilities and the Abuse Icon
CMS designates a small number of homes with persistent serious problems as Special Focus Facilities, which are inspected roughly twice as often. CMS also publishes a list of SFF candidates — homes with similar records that have not yet been selected — and both statuses appear on Care Compare.
The red hand icon flags homes cited for abuse that harmed a resident in the past year, or abuse that could have caused harm in each of the past two years. Neither marker automatically rules a home out, but each one warrants a specific question on the tour: what happened, and what has changed since?
Facilities are required to make their most recent survey results available for residents and visitors to examine. If the posted copy is missing or outdated, that itself is useful information about how the home handles transparency.
Step Three: Tour, Ideally More Than Once
Star ratings and inspection reports describe a facility's past; a tour shows you its present. Whenever possible, visit at least once outside a scheduled appointment — late morning on a weekend or during the dinner meal often reveals more than a weekday 10 a.m. tour with the admissions director.
While you are there, pay attention to what you see and hear as much as what you are told. Some signals families often watch for include:
- Call lights. Note how long call lights stay on before someone responds. Long waits during a quiet hour suggest longer ones during shift changes.
- Resident appearance. Residents should look groomed and dressed for the time of day. Many residents still in bed at midday may point to short staffing.
- Staff interaction. Listen for whether aides address residents by name and speak to them directly rather than over them.
- Odors and cleanliness. A persistent urine odor in hallways often reflects delayed incontinence care rather than a cleaning problem.
- Dining. Watch whether residents who need help eating receive it promptly and patiently.
Then, ask the administrator or director of nursing a short list of direct questions. Here are the questions that tend to produce the most useful answers:
Finally, consider calling your state's Long-Term Care Ombudsman program, which every state operates under the federal Older Americans Act. Ombudsmen cannot recommend a specific facility, but they can often share whether complaints about a home have been frequent and what kinds of issues have come up.
Step Four: Confirm a Medicaid Bed Before Admission
This is the step families most often skip, and it is the one that most often causes a second crisis months later. Nursing home costs commonly run well into five figures per year, as our 2026 nursing home cost breakdown shows, so many residents who enter as private pay eventually spend down to Medicaid eligibility.
If the home does not participate in Medicaid, or your parent is placed in a portion of the building that is not Medicaid certified, the facility may be able to discharge them once private funds run out. After all, the protections that let a resident convert to Medicaid and stay in place apply only to beds certified for Medicaid.
Before admission, confirm in writing that the facility participates in Medicaid and that your parent's bed or unit is Medicaid certified. Otherwise the home may discharge them once private funds run out.
Some facilities certify only part of their building — a "distinct part" — for Medicaid. Accordingly, it helps to ask three specific questions and request the answers in writing:
- Is the bed my parent will occupy Medicaid certified? If not, ask whether they would be moved to a certified bed upon conversion, and to which unit.
- Do you accept Medicaid-pending residents? Some homes admit residents whose applications are already filed; others admit only private pay or Medicare.
- What happens on the day private funds are exhausted? The answer should describe a payer-source change, not a discharge.
Keep in mind that federal law limits what a Medicare- or Medicaid-certified home can require at admission. It cannot require a resident to waive their right to Medicaid, and under 42 CFR 483.15(a)(3) it cannot require a third party to personally guarantee payment as a condition of admission.
Read the admission agreement closely before signing, especially any clause labeled "responsible party." An adult child who signs as the person with legal access to a parent's funds generally agrees to pay from the parent's money, but some agreements are worded more broadly — a point worth reviewing with an elder-law attorney if anything is unclear.
If your parent may need Medicaid within the next year or two, it can help to start gathering financial records now. Medicaid reviews asset transfers over a 60-month lookback period, and our guide to retroactive Medicaid coverage explains how the application timing can affect the first months of the bill.
When the Timeline Is Days, Not Weeks
Many families do this entire search while a parent is still in a hospital bed. In that situation, the order of steps stays the same, but each step compresses — a Care Compare shortlist in an evening, inspection reports read the next morning, and one unannounced tour of the top two choices.
If no preferred facility has a bed, some families accept a temporary placement for Medicare-covered rehab while staying on the waitlist for their first choice. That said, transfers between facilities can be disruptive for a parent with dementia, so weigh that cost before planning a move.
Should a facility issue a discharge notice down the road, residents have appeal rights. Our guide to nursing home discharge rights covers notice periods and how to request a hearing, and the crisis playbook collects the other urgent decisions families tend to face in the same weeks.
Putting It All Together
Overall, the search moves from broad to narrow: confirm the level of care, filter Care Compare by distance and Medicaid participation, read inspection reports for serious and repeated findings, tour with specific questions, and secure the Medicaid bed policy in writing. Each step removes a different kind of risk, and skipping any one of them tends to surface later as a harder problem.
If the financial side feels uncertain — particularly how Medicare and Medicaid divide the bill — our explainer on Medicaid vs. Medicare for long-term care is a useful next read. For questions about asset protection or admission agreements, the elder-law attorney directory can help you locate a licensed professional in your state.
This article is for informational purposes and is not financial / tax / legal / medical advice. Consult a licensed professional (CPA, elder-law attorney, HVAC contractor, state Medicaid office) before acting.