nursing home tour10 mins read

10 Nursing Home Tour Questions

Ten specific questions to ask during a nursing home tour, with guidance on how to verify answers against CMS public data.

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Adult son and daughter sitting across from a nursing home administrator at a desk during a facility tour.

GPT Image 2 / The Care Ratings illustration.

10 Questions to Ask When Touring a Nursing Home

Key Takeaways

  • Ask about RN-to-resident staffing ratios and request specific numbers; verify them against CMS Care Compare data for your state.
  • Request the facility’s most recent inspection report and ask what violations were cited; cross-check on CMS.gov within 24 hours.
  • Review the admission agreement in writing before committing; federal law prohibits requiring a third-party payment guarantee.
  • Bring a notebook and verify vague answers against public records; evasive responses are a red flag worth following up on.

Why These Questions Matter

There are 14,742 nursing facilities certified by CMS, housing about 1.24 million residents. Choosing one is not a gut-check — it is a data-gathering exercise. Staff can describe the facility’s policies and practices. Public records document what inspectors actually found.

The average nursing facility now receives 9.5 deficiency citations per survey cycle — a 40% increase from 6.8 in 2015. The CMS Five-Star Quality Rating System turns inspection, staffing, and quality data into a 1-to-5 star score you can look up before you walk through the door. The questions below help you connect what a facility tells you to what the public record confirms.

Note: federal CMS standards under 42 CFR Part 483 apply only to Medicare- and Medicaid-certified nursing homes. Assisted living facilities are regulated at the state level, with no uniform federal standards. If you are evaluating an assisted living community, contact your state’s licensing agency for the applicable requirements.

Staffing: Ask About Nurse-to-Resident Ratios

Ask the admissions coordinator: “How many hours of nursing care does each resident receive per day, and what share of those hours come from a registered nurse?” Request a specific number. A transparent facility can answer this without hesitation.

National average total nurse hours per resident day (2025)

4 HPRD

Facilities meeting all 3 staffing minimums of now-repealed 2024 rule

19%

Current national staffing benchmarks for nursing homes. Use these figures to evaluate answers during your tour.

Source: Kaiser Family Foundation, July 2025 / April 2024 data

The national average is 3.85 total nurse hours per resident day. In 2024, CMS finalized a rule requiring 3.48 total hours per resident day, including at least 0.55 hours from a registered nurse. Congress repealed that rule in July 2025 (Public Law 119-21), and CMS rescinded it in December 2025 — so those figures are no longer federally required. They remain a useful evidence-based benchmark. According to KFF analysis from April 2024, only about 19% of facilities would have met all three thresholds. Ask where this facility stands. Then verify on CMS Care Compare.

Inspection History: Ask When the Last Survey Was Conducted

Ask directly: “When was your most recent standard survey, and can I see the report?” Standard surveys are conducted by state surveyors on an unannounced basis — federal law requires them at least once every nine to fifteen months. According to KFF’s June 2026 deficiency analysis, about 87% of nursing homes received at least one standard survey in the fifteen-month period between March 2025 and May 2026. About 3% have not had a standard survey since before January 2024 — a gap worth asking about.

Surveys are unannounced, which makes them more reliable than anything a facility tells you voluntarily. One in four nursing home deficiencies come from complaint-triggered surveys — separate inspections initiated when a resident or family member files a formal complaint. Ask whether the facility has had any complaint surveys in the past two years, and what they found.

After your tour, look up the full inspection history on CMS Care Compare. Every report is public. Cross-check what the facility told you against what the record shows. For a deeper explanation of what violations mean, see nursing home inspection violations explained.

Deficiency Citations: Ask What Violations Were Found

Facilities with at least one serious deficiency (actual harm or immediate jeopardy) in 2026

28%

Share of all deficiencies reaching actual harm or immediate jeopardy

5%

Share of deficiencies identified through complaint surveys

25%

Facilities surveyed in the last 15 months (Mar 2025–May 2026)

87%

Snapshot of deficiency trends in 2026. Serious deficiencies (actual harm or immediate jeopardy) affect nearly 28% of facilities.

Source: Kaiser Family Foundation, June 2026 deficiency data

Ask: “What deficiencies did your most recent survey find, and have any been cited for actual harm or immediate jeopardy?” According to KFF’s July 2025 data, the average nursing facility receives 9.5 deficiencies per survey cycle, and 27% receive at least one deficiency classified as actual harm or immediate jeopardy — the most serious categories, defined as harm that has occurred or is likely to cause serious injury, impairment, or death. The KFF June 2026 deficiency analysis puts the share of facilities with at least one such deficiency at 28%.

About 5% of all deficiencies reach that serious threshold. Request the facility’s recent violation history and ask for specifics. Then verify on Care Compare. Discrepancies between what staff tell you and what the public record shows are important data points. Look up the facility’s health inspection star rating on Care Compare; the CMS Five-Star methodology ranks facilities within their state, with the top 10% earning 5 stars and the bottom 20% earning 1 star. See five-star nursing home ratings explained for how those rankings work.

Care Planning: Ask About Individualized Care Plans

Ask: “How quickly will my family member have a written care plan after admission, and how are family members involved in developing it?”

Under 42 CFR § 483.21, facilities must develop a baseline, person-centered care plan within 48 hours of admission. That plan must include measurable objectives covering the resident’s medical, nursing, and psychosocial needs. A facility that cannot describe this process clearly — or that treats care planning as a formality rather than a family conversation — is telling you something about how it operates.

Admission Agreement: Request the Written Agreement in Advance

Before signing anything, ask: “Can I take the admission agreement home to review before we commit?” A facility that resists this request is worth questioning.

Under 42 CFR § 483.10, facilities are required to provide a written notice of all resident rights and services at or before admission. Under 42 CFR § 483.15, facilities must disclose any special characteristics or service limitations before admission. One protection most families don’t know about: that same regulation prohibits facilities from requiring a third-party guarantee of payment as a condition of admission or continued stay. Federal regulations (42 CFR § 483.15) prohibit facilities from requiring a third-party guarantee of payment as a condition of admission or continued stay. If a facility’s admission agreement includes such a requirement, an elder law attorney can advise whether it complies with federal law.

Read the agreement carefully for any clauses requiring upfront private-pay commitments or limiting Medicaid eligibility. Medicaid is the primary payer for 63% of nursing facility residents. For questions about Medicaid eligibility or payment planning specific to your situation, contact your state’s Medicaid office or an elder law attorney.

Service Scope: Ask About Discharge Policies and Limitations

Ask: “Under what circumstances would my family member be discharged or transferred, and how much notice would we receive?”

Not every facility is equipped to handle every condition. Under 42 CFR § 483.15, a facility must disclose service limitations and special characteristics before admission. That means if a facility cannot manage certain behavioral symptoms, complex wound care, or specific medical equipment, it is required to tell you. Ask explicitly: “Are there conditions or care needs that would require my family member to be moved to another facility?” A direct answer is a good sign. Vagueness deserves a follow-up.

For assisted living facilities specifically: discharge policies vary significantly by state, because there is no uniform federal framework governing assisted living. Contact your state’s licensing agency to understand what protections apply.

How to Verify Your Answers: Use CMS Data

Every answer a facility gives you during a tour can be checked against public data. Here is where to look:

  • CMS Care Compare (medicare.gov/care-compare): Search any certified nursing home by name or zip code. You can view its overall star rating, health inspection reports, staffing hours per resident day, and self-reported quality measures. CMS posts staffing data for all certified facilities, including hours of care provided per resident per day.
  • Five-Star rating domains: The CMS Five-Star Quality Rating System scores facilities across three domains — health inspections, staffing, and quality measures — with a composite overall rating. A high overall star rating but a low health inspection rating is a pattern worth examining.
  • Special Focus Facility status: CMS publishes a list of Special Focus Facilities — nursing homes with a sustained record of poor survey performance. Facilities on the SFF list are capped at a 3-star overall rating on Care Compare. Ask the facility directly whether it is on this list, then verify.
  • Inspection reports: Standard surveys are unannounced. The full text of every inspection report, including all cited deficiencies and the facility’s plan of correction, is available on Care Compare. Read the last two survey cycles, not just the most recent one.
  • State health department: For staffing minimums above the federal floor, or for assisted living regulations, your state health department’s website is the authoritative source. The federal floor currently reflects pre-2024 standards following the repeal of the 2024 CMS minimum staffing rule.

Bring a notebook to every tour. Write down the numbers staff give you. Within 24 hours, verify them on Care Compare. Discrepancies between what you’re told and what the public record shows indicate where you need to ask follow-up questions.

About this article: TheCareRatings.com is an independent platform that aggregates publicly available data from the Centers for Medicare & Medicaid Services (CMS), the U.S. Census Bureau, the CDC, and other federal agencies. We do not accept payment from facilities for editorial coverage or rankings. This article is for informational purposes only and does not constitute medical, legal, or financial advice. Do not rely on this information alone to make care decisions. Always consult a licensed physician, attorney, or financial advisor before making decisions about nursing home admission, payment planning, or your family member’s care. Data referenced in this article was current as of August 14, 2026 and is subject to change.

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