Start with your location and care level

Finding a facility near you begins with knowing what level of care you need. Assisted living communities provide help with daily tasks like bathing, dressing, and meals, but residents manage their own medications and live more independently. Nursing homes (also called skilled nursing facilities) provide 24-hour medical care, wound management, and supervision for people with serious health conditions. The difference matters because facilities are licensed separately, and not every community offers both.

Your first step is to identify which type fits your situation. Talk with your doctor, a social worker, or a discharge planner at a hospital if you are leaving one. They can tell you whether you need skilled nursing care or whether assisted living would work. Once you know, you can search by facility type and location.

Key Takeaways

  • Medicare.gov's Care Compare tool and your state health department's facility database let you search by location, see inspection records, and compare staffing levels at no cost.
  • Assisted living communities and nursing homes are regulated differently by state, so a facility licensed in one state may not exist in another, and rules about staffing and inspections vary widely.
  • Visit any facility in person before deciding, bring a list of questions about daily routines and costs, and ask to speak with current residents or families if possible.
  • Your Area Agency on Aging (found through Eldercare Locator at 1-800-677-1116) can refer you to local options and sometimes help with cost information.
  • Costs vary by location and level of care, ranging from $3,000 to $6,000 per month for assisted living and $6,000 to $10,000 per month for nursing homes, though prices are higher in urban areas and on the coasts.

Use Medicare.gov Care Compare to search by location

Medicare's Care Compare tool (at Medicare.gov) is the fastest way to find nursing homes and some assisted living communities near you. Enter your city or ZIP code, and the tool shows all certified facilities within a chosen distance. For each one, you can see inspection records from the past three years, staffing levels, and whether the facility accepts Medicare or Medicaid.

The tool does not show every assisted living community — only those that participate in Medicare or Medicaid programs. Many private-pay assisted living facilities will not appear. But for nursing homes, Care Compare is nearly complete because most are Medicare-certified. Read the inspection summaries carefully. They list violations, how serious they were, and whether the facility corrected them. A facility with no violations is rare; what matters is whether violations involved resident safety (serious) or paperwork (less serious) and whether they were fixed.

Check your state's health department database

Your state's Department of Health or Department of Aging maintains its own searchable database of licensed facilities. These databases often include assisted living communities that Medicare.gov does not list, especially smaller or private-pay communities. Search your state's name plus "nursing home database" or "assisted living directory" to find the official link.

State databases show licensing status, recent inspection reports, and sometimes complaint histories. Some states post inspection reports online; others require you to request them. The state database is also where you can file a complaint if you have concerns about a facility after visiting. Bookmark your state's page — you will likely return to it as you narrow your choices.

Contact your Area Agency on Aging for local referrals

Your Area Agency on Aging (AAA) is a local office that connects older adults to services in your region. Call the Eldercare Locator at 1-800-677-1116, tell them your ZIP code, and they will give you the phone number and website for your AAA. Many AAAs maintain their own lists of assisted living and nursing homes, sometimes with notes about which ones have openings or specialize in certain conditions (dementia care, for example).

AAA staff can also tell you about programs that help pay for care, whether you might be on a waiting list for a particular facility, and what questions to ask during a visit. Some AAAs offer care management services where a counselor will help you evaluate options. This service is usually free or low-cost. The AAA is also a good place to ask about the reputation of a facility — staff often hear from families and can tell you if complaints are common.

What to look for and ask during a visit

Never choose a facility based on a website or phone call alone. Visit in person, and if possible, visit more than once — once during a weekday and once on a weekend or evening to see how the place runs at different times. Bring a notebook and write down what you observe: Are residents engaged or sitting alone? Do staff respond quickly when someone calls? Is the place clean? Does it smell fresh?

Ask about daily routines, meal times, activities, and how the facility handles medical emergencies. Ask about staffing — how many nurses and aides work each shift, and what happens if someone calls in sick. Ask about costs, what is included, and what costs extra (activities, outings, medications, therapy). Ask whether the facility has openings now or maintains a waiting list. Request to speak with current residents or family members if you can — their honest feedback is invaluable. Ask about the process for leaving if you or your loved one becomes unhappy with the facility.

Understand costs and payment options

Assisted living costs vary widely by location and services. In rural areas, you may find communities for $2,500 to $4,000 per month. In urban areas and on the coasts, costs often run $5,000 to $8,000 or higher. Nursing homes are more expensive, typically $5,000 to $9,000 per month in most areas, with higher costs in cities and coastal states. These figures cover room, board, and basic services; specialized care, therapy, and activities may cost more.

Most assisted living and nursing homes are private-pay, meaning you or your family pays out of pocket. Some accept Medicaid, which covers nursing home care for people who meet income and asset limits, but Medicaid coverage of assisted living varies by state — some states cover it, others do not. Medicare does not pay for assisted living or long-term nursing home care, though it does cover short-term skilled nursing after a hospital stay. Ask each facility which payment sources they accept and whether they have financial counselors who can explain options.

Narrow your list and make a decision

After visiting several facilities, create a straightforward comparison chart: location, cost, staffing levels, inspection history, and your gut feeling about the place. Weight the factors that matter most to you. If your loved one has dementia, a facility with a dedicated memory care unit and staff trained in dementia care may be worth a longer drive. If cost is the main constraint, a facility further out may be necessary, but make sure it is still reachable for visits.

Ask about trial periods or short-term stays if the facility offers them. Some communities let you stay for a week or two to see if it is a good fit before committing to a longer lease. Once you decide, read the contract carefully before signing. Understand the cancellation policy, what happens if costs rise, and what services are may provide. If anything is unclear, ask the facility to explain it in writing.

Frequently Asked Questions

How do I know if a facility is safe?

Check inspection records on Medicare.gov Care Compare or your state health department website. Look for violations related to resident safety, abuse, or neglect — these are red flags. Visit in person and observe how staff interact with residents. Ask the facility directly about their safety record and what training staff receive. Trust your instincts; if something feels off, keep looking.

What if I cannot afford assisted living or a nursing home?

Medicaid covers nursing home care in all states for people who meet income and asset limits; some states also cover assisted living through Medicaid. Your Area Agency on Aging can tell you whether you may be on a waiting list and help you understand Medicaid rules in your state. Some communities offer sliding-scale fees based on income. Ask about these options when you call.

Can I move to a facility in a different state?

Yes, but licensing rules and costs differ by state. A facility in one state may not be licensed in another. If you are considering a move, contact the health department in the state where you want to live and ask about facility options there. Your current Area Agency on Aging can also help you connect with resources in the new state.

What questions should I ask about staffing?

Ask how many nurses and certified nursing aides work each shift, what the staff-to-resident ratio is, and whether the facility uses temporary staff or agency workers. Ask what happens if someone calls in sick and whether the facility maintains a waiting list of backup staff. High turnover is a warning sign; ask how long staff typically stay. Adequate staffing is one of the strongest predictors of quality care.

How far in advance should I start looking?

Start as soon as you know a move may be needed — weeks or months ahead if possible. Some facilities have waiting lists, especially in popular areas or for specific care types. Starting early gives you time to visit multiple places, compare costs, and make a thoughtful decision rather than rushing into a choice during a crisis.