How to Choose a Nursing Home in New Jersey

By the care managers at Connections Care Management · Updated November 2026

When is a nursing home the right choice?

Nursing homes provide 24-hour nursing care under medical supervision. They serve two main groups: people who need short-term rehab after a hospital stay, and people who need long-term care because their medical needs or level of dependence are more than home care or assisted living can safely handle.

Families often come to this decision under pressure, usually during a hospital stay. Even so, you have more choice than it may seem. Take a breath and use this guide.

Step 1: Get clear on what your parent needs

• Is this short-term rehab or long-term care?
• What medical needs are involved: wound care, IV medications, oxygen, dialysis, feeding tube?
• Does your parent have dementia, and if so, do they wander or have behavioral symptoms?
• Are there mental health needs?
• Does your parent need a facility with a particular language, culture or religious practice?
• How important is being close to family for visits?

Step 2: Check ratings and inspections

Medicare’s Care Compare tool on Medicare.gov rates nursing homes with an overall star rating plus separate ratings for health inspections, staffing and quality measures. Use it as a starting filter, not the final word.

• Read the actual inspection findings, not just the stars.
• Look at staffing ratings, including weekend staffing and staff turnover if shown.
• Note any serious deficiencies and whether they were corrected.
• Check whether the facility has repeated problems in the same area.

The New Jersey Department of Health licenses nursing homes in the state. The NJ Office of the Long-Term Care Ombudsman advocates for residents and can be a useful resource if concerns come up later.

Step 3: Visit, and visit again

Nothing replaces seeing a place for yourself. Go at different times, including a mealtime and an evening or weekend if you can.

What to notice

• Do staff greet residents by name and speak kindly?
• Are call lights answered reasonably quickly?
• Are residents dressed, groomed and out of bed during the day?
• Are there strong odors, or is the building clean?
• Are residents engaged in activities, or mostly sitting in hallways?
• Does the food look and smell appetizing? Is help given to residents who need it?
• How does the staff handle a resident who is upset?

Questions to ask on a nursing home tour

Staffing and care

1. How many residents does each aide care for on day, evening and night shifts?
2. Do residents usually have the same aides from day to day?
3. Is there a physician or nurse practitioner on site, and how often?
4. How quickly can a resident be seen when something changes?
5. How do you prevent falls and pressure sores?
6. How do you manage pain?

Rehab

1. How many hours of therapy do rehab patients receive, and on which days?
2. What percentage of rehab patients return home? (Ask, even if they cannot give a precise number.)
3. How do you plan the discharge home?

Dementia and behavioral health

1. Is there a secured or specialized dementia unit?
2. What training do staff have in dementia care?
3. How do you respond to agitation or wandering? How do you limit antipsychotic medications?
4. Do you have access to psychiatric consultation?

Communication

1. How and when are care plan meetings held? Can family attend by phone or video?
2. Who is my main contact, and how do I reach them after hours?
3. How will you tell me about changes in condition, falls or medication changes?

Daily life

1. Can residents keep personal belongings and decorate their rooms?
2. What activities are offered on weekends and evenings?
3. Are religious services or visits available?
4. What are the visiting policies?

How do families pay for nursing home care?

This catches many families off guard. Under Original Medicare, skilled nursing facility coverage is short-term and tied to rehab or skilled care after a qualifying inpatient hospital stay of at least 3 days. Medicare covers up to 100 days per benefit period, with daily coinsurance after day 20, and only while skilled care is needed. Medicare does not pay for long-term custodial care.

Long-term nursing home care is usually paid by:

• Private funds.
• Long term care insurance, if your parent has a policy.
• Medicaid. In New Jersey, nursing home care for eligible people is covered through NJ FamilyCare Managed Long Term Services and Supports (MLTSS). There is a five-year look-back on transfers of assets.
• Veterans benefits in some cases.

Ask every facility whether it accepts Medicaid and what happens if a private-pay resident later becomes eligible. Rules and figures change, so confirm details with your county’s Board of Social Services or an elder law attorney. We are not attorneys, and this is general information. Our NJ Medicaid long-term care basics guide explains more.

Red flags to take seriously

• Staff who cannot answer basic questions or avoid them.
• Repeated serious inspection findings.
• Pressure to sign an admission agreement immediately.
• Agreements that ask a family member to personally guarantee payment. Have an attorney review any agreement before signing.
• Residents who appear unkempt, hungry or ignored.
• High staff turnover or heavy use of temporary staff.

After the move: stay involved

The best care often goes to residents whose families are present and engaged. Visit at varied times. Get to know the aides by name. Attend care plan meetings. Keep a simple log of concerns and raise them early and calmly. If problems are not resolved, go up the chain to the director of nursing and administrator, and contact the Long-Term Care Ombudsman if needed.

What should we bring on move-in day?

• A current medication list, insurance cards and copies of the advance directive or POLST.
• Comfortable, labeled clothing and non-slip shoes.
• Glasses, hearing aids and dentures, labeled, with cases.
• Family photos and a few familiar items from home.
• A one-page “about me” sheet: preferred name, routines, foods, what calms your loved one.

Share the “about me” sheet with the aides, not just the nurse. It helps staff see your parent as a person from day one.

How Connections Care Management can help

We know nursing homes and rehab facilities across northern New Jersey and Rockland County, and we have no financial ties to any of them. We never accept commissions or payment for referrals. We can help you narrow options, tour with you and ask the hard questions through our senior housing and placement guidance. If the decision comes during a hospital stay, our hospital discharge planning helps you move quickly without settling. After the move, our ongoing care management includes regular visits and advocacy with staff, and our benefits and paperwork help supports Medicaid applications.

Contact us for a free first conversation.