Your Complete Guide to Choosing a Medicare-Covered Nursing Home or Long-Term Care Facility

Who Should Read This

This publication is essential reading for older adults who are thinking about moving to a nursing home or who need long-term care services now or in the near future. It is also highly relevant for family members and caregivers who are helping a loved one navigate care options, especially those aged 80 and older who may be approaching the point where more support is needed.

Anyone currently on Medicare or Medicaid who is being discharged from a hospital and may need skilled nursing care should also read this guide. Adult children helping aging parents research facilities will find this publication particularly useful when comparing options and asking the right questions.

Quick Overview

This Medicare publication helps readers understand what nursing homes offer, how to find and compare them, and what to look for when making this important decision. It covers everything from understanding different types of long-term care to knowing your rights as a nursing home resident. The original publication is a detailed, step-by-step guide designed to make a complex decision easier to navigate.

Key Takeaways

• Nursing homes provide two main types of care: skilled nursing care and custodial care, and Medicare covers them differently.
• You can use the Medicare Care Compare tool at Medicare.gov to research and compare nursing homes in your area.
• Visiting a nursing home in person — and more than once — is one of the most important steps in the selection process.
• Every nursing home that accepts Medicare or Medicaid must follow federal standards for quality and resident rights.
• Residents have legal rights, including the right to privacy, dignity, and the ability to participate in their own care planning.
• Family members and loved ones can be actively involved in care decisions and should be included in care planning meetings.
• If you are unhappy with the care provided, there are formal processes and Long-Term Care Ombudsman programs available to help resolve complaints.

Publication Summary

Understanding Types of Long-Term Care

Not all nursing home care is the same. This publication explains the key difference between skilled nursing care and custodial care. Skilled nursing care is short-term medical care provided by licensed professionals such as nurses or physical therapists. This type of care may be covered by Medicare under specific conditions. Custodial care, on the other hand, helps with everyday activities like bathing, dressing, and eating. Medicare generally does not cover custodial care, and this is an important distinction for anyone planning ahead for long-term needs.

How to Find and Compare Nursing Homes

The publication strongly encourages the use of Medicare's Care Compare website, which is available at Medicare.gov. This free online tool allows you to search for nursing homes by location and compare them based on health inspections, staffing levels, and quality measures. These ratings come from official inspections and data submitted by the facilities themselves, giving you a more objective way to evaluate your options before visiting.

Beyond online research, the guide recommends talking to your doctor, a hospital discharge planner, or a social worker for personal recommendations. These professionals often have insight into local facilities that may not be captured in online ratings alone.

What to Look for When You Visit

The publication places strong emphasis on in-person visits. It recommends visiting more than once and at different times of day so you can get a true picture of the facility's operations. During your visit, you should pay attention to how staff interact with residents, whether the facility is clean and free of odors, and whether residents appear comfortable and engaged.

The guide provides a helpful checklist of questions to ask during your visit, covering areas such as staffing ratios, how the facility handles medical emergencies, what activities are available, and how family members can stay involved in a resident's care. These questions help you go beyond appearances and understand the day-to-day reality of living in that facility.

Understanding Costs and Payment Options

One of the most important sections of this publication covers how nursing home care is paid for. Medicare may cover short-term skilled nursing facility care following a qualifying hospital stay, but coverage has limits and specific requirements. Medicaid may cover long-term nursing home care for those who meet income and asset requirements. Some people use long-term care insurance or personal savings to cover costs that Medicare and Medicaid do not pay.

The publication encourages readers to understand their payment options before making a choice and to ask facilities directly about what is and is not included in the base cost of care.

Resident Rights

Every resident in a Medicare- or Medicaid-certified nursing home has federally protected rights. These rights include the right to be treated with dignity and respect, the right to privacy, the right to manage their own finances, and the right to participate in their own care planning. Residents also have the right to refuse treatment and to be informed about their medical condition and care options.

The publication highlights that nursing homes are required to provide a written description of resident rights to every new resident upon admission. Understanding these rights can help residents and families advocate for the best possible care experience.

How to Handle Complaints

If a resident or family member has a concern about the quality of care, the publication explains that there are several options for getting help. First, raising the concern directly with the nursing home's staff or management is encouraged. If the issue is not resolved, every state has a Long-Term Care Ombudsman program. Ombudsmen are trained advocates who help nursing home residents and their families resolve complaints at no cost. Contact information for your state's Ombudsman program can be found through Medicare.gov or by calling 1-800-MEDICARE.

Frequently Asked Questions

Does Medicare pay for long-term nursing home care?

Medicare covers short-term skilled nursing facility care following a qualifying hospital stay of at least three days, but it does not typically cover long-term custodial care such as help with bathing and dressing. Medicaid may cover long-term care for those who qualify based on income and assets.

How do I find and compare nursing homes in my area?

You can use the Care Compare tool on Medicare.gov to search for nursing homes near you. The tool provides ratings based on health inspections, staffing, and quality measures, helping you make a more informed comparison before you visit.

What rights does a nursing home resident have?

Residents in Medicare- or Medicaid-certified nursing homes have federally protected rights, including the right to dignity, privacy, participation in care planning, and the ability to file complaints without fear of retaliation. Facilities are required to inform residents of these rights in writing when they are admitted.

What should I look for when visiting a nursing home?

Pay attention to cleanliness, how staff interact with residents, the overall atmosphere, and whether residents appear comfortable and cared for. Ask questions about staffing levels, emergency procedures, activities, and family involvement. Visiting at different times of day gives you a fuller picture of the facility.

What can I do if I am unhappy with care at a nursing home?

Start by speaking with the nursing home's staff or administration. If the problem is not resolved, contact your state's Long-Term Care Ombudsman program, which provides free, confidential help for residents and families dealing with nursing home complaints. You can find your state's Ombudsman through Medicare.gov.

Access the Full Publication

Publication Number: 02174
Publication Date: September 2025
Length: 16 pages