Nursing Home Tour Checklist: What to Look For

A practical nursing home tour checklist covering smells, staffing, safety, food, activities, and the questions to ask before you leave.

Category: touring-and-evaluation · Updated 2026

A tour is your best chance to see a nursing home as it really operates, not as it is described in a brochure. The facility controls the schedule and the route, so go in with a plan. Notice the senses first, then ask about the things no marketing sheet will volunteer: staffing at night, turnover, how complaints are handled, and what happens when needs increase. Take notes and bring a second set of eyes if you can.

This checklist walks through what to observe and what to ask. Pair it with the facility's CMS data on Care Compare before you go.

Before the visit: prepare

Pull the facility's CMS star ratings, staffing, and recent inspection results
Write down the specific care needs of your family member
List your top ten questions and leave room for answers
Ask for a tour during a normal activity time, not a staged hour
Request to see the unit where your family member would actually live

What to observe on the walk-through

Area	Look and listen for
Smells	Odor of urine or stool that lingers suggests slow response to care
Noise	Call bells ringing unanswered, or residents calling out without staff responding
Residents	Grooming, positioning, engagement, and whether they are up and dressed
Staff	How many staff you see, whether they greet residents by name, how they speak to people
Safety	Handrails, clear paths, call cords in reach, grab bars, well-lit hallways
Cleanliness	Bathrooms, dining areas, and equipment; not just the lobby
Food	Ask to see a meal, taste it if allowed, and watch whether residents get help eating
Activities	A posted schedule that is actually happening, not just on paper

Staffing questions

Staffing is the single strongest operational signal. Federal rules require a licensed nurse on duty 24 hours a day and an RN on duty at least 8 consecutive hours a day, 7 days a week, under 42 CFR §483.35. Ask:

How many certified nursing assistants are on the floor on day and night shifts?
What is the ratio of residents to direct-care staff on each shift?
Is a registered nurse on site overnight, and who covers clinical problems at 2 a.m.?
What is the total nursing staff turnover rate, and the RN turnover rate?
How are shifts covered when someone calls out sick?

Compare the answers with the facility's CMS staffing and turnover data. See CMS Staffing Ratings Explained.

Care and safety questions

How is the care plan built, and how often is it reviewed with the family?
How are falls tracked and prevented?
What is the infection control and outbreak plan?
How are medications managed, and who administers them?
What happens if a resident's needs increase beyond what this facility can provide?
How are complaints logged and resolved?
Is there a resident council, and when does it meet?

Under 42 CFR §483.10, residents have the right to participate in their care plan and to voice grievances without retaliation. Ask how the facility puts that into practice.

After the tour

Before you leave, ask to walk back through the unit unaccompanied, and ask for a copy of the activities calendar and the current rate sheet. Then visit a second time at a different hour, ideally in the evening or on a weekend, when staffing is often thinner. Compare notes with the CMS data. If something felt off, trust the feeling and investigate it. See Questions to Ask on a Facility Tour.

Sources: CMS Care Compare; 42 CFR Part 483, Subpart B; CMS Nursing Home Quality.

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Frequently asked questions

How many times should I tour a facility?

At least twice, at different times of day. A weekday morning tour shows the facility at its best-staffed. A weekend or evening visit shows how it runs when staffing is thinner.

Can I talk to current residents and families?

Yes, and you should. Ask the facility for permission to speak with residents or family members in common areas. Their candid impressions often fill in what staff cannot say.

What is the biggest red flag on a tour?

Unanswered call bells and persistent odors are among the most telling signs, because they suggest staff cannot respond promptly to basic needs. Combine what you observe with the facility's staffing and inspection data.

Should I ask for the inspection report during the tour?

Yes. Ask for the most recent survey results and the plan of correction. You can also read them on Care Compare before you visit.

What if the facility won't answer staffing questions?

A refusal to give basic staffing and turnover numbers is itself information. Cross-check with CMS data, and ask the administrator in writing so you have a record.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is informational and is not medical advice. Processing date: 2026-10-05.

Important disclosures

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