Lifestyle
6 Things Nursing Homes Hope You Never Ask Before You Sign
By Erica Coleman · October 17, 2026
Families often tour a nursing home under pressure, after a hospital discharge or a sudden decline at home. The lobby looks calm. The brochure looks polished. The paperwork looks endless.
Federal rules and Medicare’s own checklists give you permission to slow that process down. Medicare.gov Care Compare and CMS’s nursing home checklist exist so you can compare facilities on paper before you commit. Here are six questions worth asking out loud before anyone signs.
What did the last inspection actually find? CMS requires nursing homes to make the most recent state or federal survey report available in a public place. Medicare’s checklist tells you to ask whether the inspection report shows quality-of-care problems or other citations, and whether every citation on the last report has been corrected. You can also pull older reports on Medicare.gov/care-compare. A clean lobby does not erase an open deficiency.
How many nurses and aides will be on my floor at night and on weekends? Facilities must post staffing levels where residents can see them. The Medicare checklist asks how many nurses, including certified nurse aides, will be available during the day, at night, and on weekends, and whether the same staff will care for you day to day. Care Compare also rates staffing separately from the overall score, and CMS has added staff turnover and weekend staffing measures to that picture.
Who pays when Medicare’s skilled days run out? Medicare Part A covers skilled nursing facility care for a limited time after a qualifying hospital stay. For 2026, Medicare.gov says you pay $0 for days 1 through 20 after the Part A deductible, $217 a day for days 21 through 100, and all costs for day 101 and beyond. Medicare does not cover non-medical long-term care if that is the only care you need. Ask the business office, in writing, what the private-pay daily rate is and which payer would take over.
Can I refuse the arbitration agreement and still get a bed? CMS’s 2019 arbitration rule says a long-term care facility must not require a resident or representative to sign a binding arbitration agreement as a condition of admission or continued care. The agreement has to be explained in a language you understand, and you have to acknowledge that you understand it. If a packet treats arbitration as non-negotiable, ask them to point to how that squares with the rule.
What happens to my bed if I go back to the hospital? Medicare’s skilled nursing booklet tells families to ask the facility if it will hold a bed and whether there is a cost. Bed-hold rules also vary by state for Medicaid residents. Get the policy in writing before a crisis forces the question.
How should I read the Five-Star rating? CMS created the Five-Star Quality Rating System so families can compare homes more easily. Each home gets an overall rating plus separate stars for health inspections, staffing, and quality measures. Five stars means much above average. One star means much below average. CMS itself cautions that no rating system covers everything that matters, including how easy visits will be. Use the stars with a tour, the inspection report, and a call to your state Long-Term Care Ombudsman.
None of these questions is hostile. They are the same prompts Medicare publishes for consumers. Asking them early is usually easier than untangling a bad fit after the move-in date.
This article is for general information and is not legal, financial, or medical advice. Confirm coverage, costs, and facility policies with Medicare, your state survey agency, and the nursing home in writing before you sign.