Choosing the Right Nursing Home or Assisted Living Center

Nursing homes, whether called skilled nursing facilities, residential care facilities, memory care centers, or assisted living centers, now rival restaurant chains as a growing presence on the American landscape. The increase in the number of facilities reflects the number of Americans needing some kind of long-term care. Approximately 1.6 million Americans live in nursing homes today, and nearly half of all Americans will eventually become residents of a facility at some point in their lives.

We have handled a significant number of cases involving nursing home neglect or abuse and they are always tragic. Federal and state laws require that a nursing home have an adequate number of qualified staff and that each resident’s specific needs are met. Under the Federal Nursing Home Reform Act, it is a nursing home’s obligation to provide services and activities to attain or maintain the highest physical, mental and psychosocial well-being of each resident. When a facility fails to assess the individual needs of a resident, fails to plan care around those needs, and fails to deliver the care the resident needs, residents can be injured or deprived of the care they need to survive.

What You Need to Know

There are three levels of care facilities in Oregon, each governed by a different set of regulations: skilled nursing facilities, residential care facilities, and assisted living facilities. You should determine what level of care is needed for the intended resident.

Here are six actions you can take to help you make an informed decision:

    1. Go online to the Oregon Department of Human Services website to find any substantiated complaints against the facilities that you are considering. The data on the website is not entirely up to date and does not include complaints that were made but not substantiated. This agency also has a pamphlet about choosing nursing homes.
    2. Visit your local Seniors and People with Disabilities office. The office should have a file of annual surveys of each facility, with its written evaluation of the facility. The office should also have a file of all complaints filed against the facility, including complaints that were not substantiated. You can read the complaints and surveys there at the office.
    3. Review the nursing home’s compliance with state and federal regulations on the Medicare website.  This website covers skilled nursing facilities that receive Medicare funds. It allows you to type in a zip code, see the facilities in that area, and what their ratings are.
    4. Seek the advice of knowledgeable physicians, nurses, physical therapists, and friends.
    5. Consider the preferences and personality of the person to reside in the facility.


  1. Take a formal tour of the facility, plus unannounced visits during all three shifts. Observe staff and their interactions with residents. Check out the sights and smells. Are residents engaged in activities? Does the food appear appetizing? Does staff assist residents to eat or drink if needed? Are staff responding to call lights in a timely fashion? Do the residents appear well groomed? Ask family members of other residents about their experiences at the facility.

If you have decided on a facility, the office staff at the facility will most likely ask you to sign a residency agreement on behalf of yourself or your loved one (if they do not have the ability to read and sign the agreement on their own). If the residency agreement has an arbitration clause, which might result in you or your loved one forfeiting a constitutional right to a jury trial if the facility is negligent or abusive, you should ask the office staff for time to consult with an attorney before signing the arbitration clause. Admission to the nursing home should not be conditioned on the signing away of constitutional rights.