The basic steps to move someone into a nursing home
Moving someone into a nursing home involves three main steps: finding a facility that has an open bed and will accept the person, completing the facility's admission paperwork, and arranging payment or insurance coverage. The person moving in (or their legal representative) meets with the nursing home's admissions staff, who review medical records and confirm the facility can meet that person's care needs. Once both sides agree, you sign an admission agreement, arrange for the person's belongings and medical records to be transferred, and set a move-in date.
The timeline varies. Some facilities have beds available when ready; others have waiting lists that can stretch weeks or months. If the person is currently in a hospital, the hospital's discharge planner can often speed up the process by contacting facilities directly. If the person is at home, you have more flexibility to search and compare options before deciding.
Key Takeaways
- Start by getting the person's medical records and a clear picture of what level of care they need — skilled nursing, assisted living, or memory care — because not all facilities offer all levels.
- Contact nursing homes directly or use your state's nursing home finder tool to see which facilities have beds available and accept the person's insurance or payment method.
- The admissions staff will ask about the person's medical history, medications, mobility, and any behavioral or cognitive concerns to confirm they can provide appropriate care.
- You will need to sign an admission agreement that outlines the facility's services, costs, what the person can bring, visiting rules, and what happens if the person needs to leave.
- Arrange for the person's medical records, medications, and a few personal items to arrive before or on the move-in date so the nursing home can begin care without delay.
Deciding whether a nursing home is the right choice
Before contacting facilities, be clear about why a nursing home is being considered. Nursing homes provide 24-hour skilled nursing care, which means a registered nurse is on staff and can manage complex medical needs like wound care, medication management, or post-surgery recovery. If the person needs help with daily tasks like bathing or dressing but does not need skilled nursing, an assisted living facility or in-home care may be less restrictive and less costly.
Talk with the person's doctor about what level of care they actually need. The doctor can write a recommendation that will help nursing homes understand whether they are a good fit. If the person has dementia or significant confusion, ask whether the facility has a dedicated memory care unit, because not all do. If the person uses a wheelchair or has mobility challenges, confirm the facility has accessible bathrooms and common areas.
If the person is still living at home, consider whether family members or paid caregivers could meet their needs there instead. Home care, adult day programs, and modifications to the home (grab bars, ramps, better lighting) sometimes delay or prevent the need for a facility move. A geriatric care manager or social worker can help you think through these options.
Finding nursing homes and checking availability
Your state's health department maintains a list of all licensed nursing homes, usually available on the department's website. You can also search by location, bed type, and whether the facility accepts Medicare or Medicaid. The federal government runs Nursing Home Compare (Medicare.gov), which shows inspection records, staffing levels, and resident complaints for every nursing home in the country. Use it to narrow your list to facilities with good inspection histories and adequate staffing.
Call the facilities directly and ask whether they have a bed available in the care level the person needs. Many nursing homes have waiting lists, so ask how long the wait is and whether you can be added to the list. Ask what insurance or payment methods they accept — some take Medicare, some take Medicaid, some require private pay, and many accept a combination. If cost is a concern, ask whether the facility accepts Medicaid and, if so, whether it will hold a bed while you complete the Medicaid process.
Visit the facility in person if possible. Walk through the halls, look at a sample room, observe how staff interact with residents, and ask to speak with current residents or their families. If the person is able to visit, bring them along so they can see the space and meet staff. A good fit matters for how well the person adjusts.
Preparing medical records and information for admission
Gather the person's medical records from their doctor, any specialists they see, and any hospitals or clinics where they have been treated recently. The nursing home will need a current list of all medications with dosages, a summary of medical conditions, any allergies, and the names and phone numbers of their doctors. If the person has had recent lab work or imaging (X-rays, CT scans), bring those results too.
Ask the person's doctor to write a letter of recommendation or medical summary that explains why the person needs nursing home care. This helps the admissions staff understand the person's needs and confirms the facility is appropriate. If the person is coming from a hospital, the hospital's discharge summary will contain much of this information — ask the hospital to send it directly to the nursing home.
Prepare a list of the person's legal documents: Medicare card, Medicaid card (if they have one), insurance information, Social Security number, and the name and contact information of anyone with power of attorney or healthcare proxy authority. If the person does not have a healthcare proxy or power of attorney in place and is not able to make decisions for themselves, you may need to pursue guardianship or conservatorship before the nursing home will accept them — ask the admissions staff whether this is required.
Understanding the admission agreement and costs
The nursing home will provide an admission agreement — a contract that outlines what services the facility provides, what it costs, what the person can bring, visiting hours, what happens if the person's condition changes and they need to leave, and other policies. Read this carefully before signing. Ask questions about anything unclear.
The agreement should specify the monthly cost and what is included in that cost (room, meals, basic nursing care, activities). It should also list what costs extra (phone service, cable, personal care items, specialized therapies). Ask whether the cost changes if the person's care needs increase. Ask what the facility's policy is if the person runs out of money — will they continue to accept Medicaid, or will they ask the family to pay privately?
The agreement should also explain the facility's discharge policy — under what circumstances they can ask the person to leave. Nursing homes can discharge residents if they can no longer meet the person's care needs, if the person is a danger to themselves or others, or if the person does not pay. Understand these terms before signing.
Arranging the move and the first days
Once admission is approved, work with the nursing home to set a move-in date. A few days before the move, confirm that the person's medical records and medication list have arrived at the facility. Call the admissions office to confirm the room number and ask what time you should arrive on move-in day.
Pack a small bag of the person's belongings — comfortable clothes, underwear, socks, toiletries, glasses or hearing aids if they use them, and a few items that feel like home (photos, a favorite blanket, a small radio). Label everything with the person's name. Most nursing homes provide sheets and towels, so you do not need to bring those. Ask the facility what items are not allowed (some prohibit candles, hot plates, or certain electrical items for safety reasons).
On move-in day, arrive early enough to help the person settle in and meet the nursing staff. Ask to speak with the charge nurse about the person's routine — when meals are served, when medications are given, when activities happen, and how to reach staff if you have questions. Leave your phone number and let the person know you will visit soon. The first few days are an adjustment; many people feel confused or sad. Regular visits and reassurance help.
What to do if the person cannot afford a nursing home
If the person does not have savings or insurance to pay for a nursing home, Medicaid may cover the cost. Medicaid is a joint federal and state program that pays for nursing home care for people with low income and limited assets. Each state has different rules about income and asset limits, so contact your state's Medicaid office or a local Area Agency on Aging to learn whether the person qualifies.
The Medicaid process process takes time — often several weeks or months. During this time, the person may be in a hospital or temporary care setting. Some nursing homes will admit a person while the Medicaid process is pending, but they may ask the family to sign an agreement to pay privately if Medicaid is denied. Ask the facility about this before admission.
If the person has some assets but not enough to pay for long-term nursing home care, a Medicaid planner or elder law attorney can advise on legal strategies to preserve assets while the person becomes Medicaid-may be able to access. This is a specialized area of law, and the cost of consultation may be worth it if the person has significant assets.
Frequently Asked Questions
Can I move someone into a nursing home without their permission?
If the person has the mental capacity to make decisions, they must consent to the move. If they lack capacity and have not named a healthcare proxy or power of attorney, you may need to pursue guardianship through the court, which gives you legal authority to make decisions on their behalf. This process takes weeks and requires a lawyer. If the person is in a hospital and medically ready to leave, the hospital's social worker can sometimes facilitate a temporary move while guardianship is being pursued.
How long does the admission process take?
If a bed is available and the person's medical records are in order, admission can happen within a few days. If there is a waiting list, it may take weeks or months. If the person needs Medicaid and does not yet may have access to, the process can take several months. Ask the facility for a timeline when you first contact them.
What if the person wants to leave after they move in?
If the person has capacity to make decisions, they can leave. If they lack capacity, the person with healthcare proxy or power of attorney authority can authorize discharge. The nursing home may ask the person's doctor whether discharge is medically safe, but they cannot force someone to stay. If you are concerned about the person's safety outside the facility, talk with their doctor and the nursing home social worker about options.
Do I need a lawyer to move someone into a nursing home?
You do not need a lawyer for a straightforward admission if the person consents and has the legal documents in place (healthcare proxy, power of attorney). You may need a lawyer if the person lacks capacity and you need to pursue guardianship, or if you are planning Medicaid spend-down strategies to preserve assets. An elder law attorney can review the admission agreement before you sign if you have concerns.
What happens if the nursing home says they cannot care for the person?
A nursing home can decline admission if they believe they cannot meet the person's care needs safely. This sometimes happens if the person has very high medical needs, severe behavioral issues, or needs that require specialized equipment the facility does not have. Ask the admissions staff specifically what their concern is, and ask whether they can recommend another facility that might be a better fit. Your state's ombudsman office can also help you find appropriate placement.