How to Avoid the 'Ick' Factor When Choosing Long-Term Care

Experts say knowing what to look for can make a critical difference when selecting a nursing home or assisted living facility.

Published on Feb. 13, 2026

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The need to move to a long-term care facility often comes suddenly, setting off an abrupt and daunting search. Experts say knowing what to look for, such as government ratings, staffing levels, and a facility's overall feel and culture, can make a big difference in finding the right fit. Paying attention to small details and trusting your gut instinct are also key when evaluating potential options.

Why it matters

Choosing the right long-term care facility is a critical decision that can greatly impact a person's quality of life. With regulation and standards varying greatly across states, it's important for families to be informed consumers and advocates when navigating this process, which is often stressful and time-sensitive.

The details

When looking for a long-term care facility, experts recommend starting with government ratings for nursing homes, which are monitored by the Centers for Medicare and Medicaid Services. While the star ratings can be unreliable due to self-reported data, they can help rule out the worst options. Visiting potential facilities in person is crucial, looking past the lobby decor to observe the overall culture, cleanliness, and how staff interact with residents. Staffing levels are the most important factor, as higher staffing correlates with better care. Asking about a facility's Medicaid policies and potential for cost increases over time is also advised to ensure long-term sustainability.

  • The need to move to a long-term care facility often comes suddenly.

The players

Centers for Medicare and Medicaid Services

The federal agency that monitors and rates nursing homes across the United States.

Sam Brooks

Director of public policy for the National Consumer Voice for Quality Long-Term Care.

Mark Sanchez

CEO of United Hebrew, a nursing home in New Rochelle, New York.

Jennifer Fink

A California resident who recently chose a memory care community for her mother.

Evan Farr

An elder law attorney in Lorton, Virginia, and author of "The Nursing Home Survival Guide."

Geoff Hoatson

Founder of the elder law practice Family First Firm in Winter Park, Florida.

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What they’re saying

“One or two stars, expect it to be bad.”

— Sam Brooks, Director of public policy, National Consumer Voice for Quality Long-Term Care

“When I tour a building, I listen first. Is it loud? Are call bells ringing nonstop?”

— Mark Sanchez, CEO, United Hebrew

“Trust your gut. Keep top of mind that the salesperson wants your loved one's money. If it's giving you the 'ick,' then move on.”

— Jennifer Fink

“These are the times when staffing is reduced and the true operation of the facility becomes apparent. It is entirely possible to have a five-star rated facility that is woefully under-staffed from 5 p.m. Friday until 8 a.m. Monday morning.”

— Evan Farr, Elder law attorney, author of "The Nursing Home Survival Guide"

“Four-thousand dollars a month can become $8,000 overnight.”

— Geoff Hoatson, Founder, Family First Firm

The takeaway

Choosing the right long-term care facility requires diligent research, in-person visits, and a keen eye for details that can reveal the true quality of care. By focusing on factors like staffing, culture, and financial sustainability, families can find a facility that meets their loved one's needs while avoiding the 'ick factor' that can come with substandard care.