Gerontology Expert: Six Questions You Should Ask Before Choosing a Nursing Home

Jim Ellor
(Courtesy photo)
May 14, 2014

Baylor Social Work professor offers advice during National Nursing Home Week

Follow us on Twitter: @BaylorUMediaCom

Contact: Eric Eckert, 254-710-1964

WACO, Texas (May 13, 2014) – “Use your nose.”

That used to be standard advice given to people searching for prospective nursing homes for themselves or their loved ones.

The sentiment behind the advice was to prompt people to use their olfactory sense to determine whether a facility was clean, practiced proper hygiene, etc., explained James Ellor, Ph.D., professor in Baylor University’s School of Social Work and gerontology expert.

But now – during a time when nursing facilities and hospitals pay extra for specially designed, odor-neutralizing waxes and paint – people need to be aware of more subtle clues to help them find the best facility.

During this year’s National Nursing Home Week (May 11-17), Ellor offers six questions people should ask while investigating – and before choosing – a nursing home.

1. What is the turnover rate for nurse’s aides?

“Nurse’s aides are the backbone of care,” Ellor said. “In some cases, we’ve seen an average turnover of three months. That’s not good.”

2. Does the patient’s doctor serve the facility?

“When you’re under the care of your physician, you’re going to get better treatment,” Ellor said. “Also, you need to assess the reputation of the medical director.”

3. What is the status of the facility’s recreation and social services?

In general, Ellor said, nonprofit facilities will have more chaplains, social workers and recreation therapists on staff than their for-profit counterparts. He advises potential clients and their families to check whether the recreation therapist is certified.

“Some facilities will hire someone who can operate an arts-and-crafts system, but he or she is not a certified therapist,” Ellor said. “The ideal situation is for a certified recreation therapist to be supervised by an occupational therapist on staff.”

He also advises to look for recreation and therapy equipment, including stairs, therapy balls and other rehabilitation tools. The presence of ample equipment can be evidence of a thriving rehabilitation and recreation program, he said.

4. What is the reputation of the nursing staff?

Ellor advises potential residents to do due diligence by checking the facility’s record with the state’s board of public health and by questioning a nursing home ombudsman.

“A nursing home ombudsman can often tell you whether a facility has had a number of problems,” he said. “The board of public health can tell you if the place has received any citations.”

5. Is the facility accredited?

Ellor said accreditation is not always a deal breaker, but accreditation shows that the facility has taken extra steps to comply with The Joint Commission, formerly known as the Joint Commission on Accreditation of Hospitals (JCOAH).

“A handful of nursing homes are accredited,” he said. “This is strictly voluntary on the part of the facility, but it shows that they’ve taken extra steps.”

6. How is the environment?

This question addresses everything from “Are there plants in the rooms and hallways?” to “Is the facility operated based on the needs of the staff or the needs of the patient?”

Of the latter example, Ellor said, “Are the patients awakened by the night shift in the wee hours of the morning to accommodate staffing schedules, or are they allowed to wake up on their own time?”

Ellor said organizations such as Pioneer Project and Eden Experiment monitor these types of things and can provide reliable resources for investigation purposes.


Baylor University is a private Christian university and a nationally ranked research institution, characterized as having “high research activity” by the Carnegie Foundation for the Advancement of Teaching. The university provides a vibrant campus community for approximately 15,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating university in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 11 nationally recognized academic divisions. Baylor sponsors 19 varsity athletic teams and is a founding member of the Big 12 Conference.


The Baylor University School of Social Work is home to one of the leading graduate social work programs in the nation with a research agenda focused on the integration of faith and practice. Upholding its mission of preparing social workers in a Christian context for worldwide service and leadership, the School offers a baccalaureate degree (BSW), a Master of Social Work (MSW) degree and three joint-degree options (MSW/Master of Business Administration, MSW/Master of Divinity and MSW/Master of Theological Studies) through a partnership with Baylor’s Hankamer School of Business and George W. Truett Theological Seminary. Visit to learn more.

Looking for more news from Baylor University?