As the U.S. population ages, more Americans are expected to need the services of nursing homes – around 2.7 million people by 2040, according to one projection. If you or a loved one are among them, there are some steps you can take to locate places that might work among the approximately 16,000 facilities located around the United States.

One good way to start your research is to check the growing number of resources available online. The Centers for Medicare and Medicaid Services, the federal agency that oversees Medicare, offers a helpful database that you can find on the Medicare Web site. Click on “Compare Nursing Homes in Your Area,” at the bottom of the page.

The database will let you search for homes by location, by name or according to other characteristics that matter to you. It offers a rating of the nursing home’s quality, ranging from one to five stars, with five being the best. The Medicare database includes a lot of other information that will matter to you: health inspection results, nursing home staffing numbers and fire safety findings, among other things. The database also highlights the nursing homes that are considered the most troubled, known as “special focus facilities.”

Among the key measures to look at in the federal site are information on pain management, pressure sores and the use of physical restraints. Other variables may simply reflect the population of a nursing home, as much as the quality of its care. An example is the percentage of residents whose need for help with daily activities has increased. Also, keep in mind that several of the measures in the Medicare site are self-reported by nursing homes, and the inspections, typically performed by state regulators, may vary in thoroughness and in how recent they are.

A number of other Web sites crunch the same data as the federal database, but boil down the information differently. One is, maintained by a small company based in Severna Park, Md. The site, which is free, offers color-coded ratings based on the federal nursing-home data., offered by Health Grades Inc., charges for its reports, though their quality findings too are based on the inspection data used in the federal site. has some nursing-home and assisted living information, but it may not be recent.

Internet research on nationally-focused sites is only a starting point. Many states have their own nursing-home information sites, which are often more in-depth than the broader Web tools. There are also a number of state and local resources you can tap in your research. You should ask for advice on what to look for, and information on good locations, as well as for help interpreting the data you’ve already turned up. States often have long-term care ombudsmen. To find the one for your state, you can go to the National Long-Term Care Resource Center, and click on your state to get a contact information for local ombudsmen.

Various federal government sites can guide you toward the best state and local groups. One good place to go is, which helps you search for nonprofit and government entities in your area that specialize in helping older adults. Among these should be area agencies on aging.

The site also has a helpful “Guide to Choosing a Nursing Home” that includes good advice, and it can point you toward various state and local agencies. The link to it is found under the Nursing Home Compare database form. Among the destinations listed in this guide are state health insurance assistance programs, which advise Medicare recipients on insurance and other issues, state medical assistance offices, which can explain about state programs that help pay nursing home costs for people with limited resources, and state survey agencies, which handle quality issues about nursing homes.

Finally – though most important of all – you want to make sure that you visit any nursing home you are considering as a destination for yourself or a family member. In fact, you want to visit repeatedly and without warning. You should ask to see the home’s most recent inspection form, which is supposed to be available to you during an in-person visit. Spend considerable time at the home, checking out how caregivers go about their work and how residents are treated.

The Medicare guide, as well as sites like and, include lists of things to ask and examine. AARP even has a printable form that you can literally use to check off various points. The detailed questions include everything from “Do the hallways have handrails?” to “Does the staff knock before entering a resident’s room?” and “Are background checks conducted on all the staff?”

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Filed under: Elder Care