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What to ask on a tour — and what to look up first

The tour is designed. The lunch is good, the corridor you walk down is the best one, and the administrator answering your questions is practised at it. None of that is dishonest, but none of it is the record either.

The single thing that changes a tour is walking in already holding the facility's government record. It moves you from "tell me about this place" to "tell me about this", and those two conversations go differently.

Before you go

Look the facility up and write down what you find. For a Medicare-certified nursing home that means the star ratings, the payroll-based staffing figures, the nurse turnover rate, any fines, and every citation with its scope and severity code. The 29 nursing homes published here carry 621 health citations between them, 19 of the 29 facilities have at least one graded at immediate jeopardy, and every one of those findings is public.

This is general information, not medical advice. It describes what Texas and Medicare require, not what any particular person needs. Talk to your parent's physician about their specific situation.

Questions that come from the record

Each of these is a question you can only ask having looked something up first. Take the specific finding, figure or date with you and put it in the question — the version with a number in it gets a different answer from the version without one.

• What changed after the citations in your last inspection?

  Name the specific finding and the date you read. This is the question a brochure cannot answer, and the one where a vague reply is itself an answer.

• Your staffing is payroll-reported. Is that what a Tuesday night actually looks like?

  CMS staffing figures come from payroll data rather than a facility's own estimate, so they are unusually hard to dress up. Ask about nights and weekends specifically — the weekend figure is reported separately for a reason.

• What is your nurse turnover now, and what was it a year ago?

  Turnover is the number that most reliably predicts what a family experiences day to day, and it is the one least likely to come up on a tour unprompted. The reported figure gives you something to compare the answer against.

• Who will actually be caring for my parent, and how many other residents will they have?

  Ask for the ratio on the specific unit your parent would live on, on a night shift, not the building average.

• What happens the night my parent falls?

  Who is in the building, who is called, how long it takes, and who tells you. Ask them to walk through it start to finish.

If you are touring assisted living in Texas

The record is thinner, because Texas publishes no rating and no inspection score for assisted living. What exists is the licence, and it answers questions a tour will not:

• Is this a Type A or a Type B licence?

  It decides whether the facility may accept residents who cannot evacuate without help, and whether Texas requires it to staff overnight. What each licence permits.

• Are you certified by Texas for memory care?

  A separate state certification, and a facility without one may not hold itself out as providing dementia care. How to check.

• What happens if my parent's needs change?

  A facility cannot lawfully keep a resident whose needs have moved beyond what its licence permits. Ask what that point looks like and what happens when it arrives.

What a real answer sounds like

Specific, dated, and unsurprised. An administrator who knows their own findings, can say what was corrected and when, and does not need to look it up is describing a building someone is paying attention to. Reassurance without detail is not the same thing, and neither is a promise about the future.

None of this makes the decision. It is not possible for a website to tell you where your parent should live, and this one will not pretend otherwise — what it can do is make sure you walk in knowing what the government already knows.

Common questions

What should I ask on a nursing home tour?

Ask about what is already on the facility's public record, because those questions cannot be answered with a brochure. Bring the specific citations from the last inspection, the payroll-reported staffing numbers and the nurse turnover rate, and ask what changed after each one. A specific answer with a date attached tells you more than a reassuring one.

What should I look up before a tour?

For a nursing home: the CMS star ratings, the staffing and turnover figures, every citation with its scope and severity code, and any fines. For a Texas assisted living facility: the licence type, the licensed capacity, and whether the state has certified it for memory care. All of it is public, and all of it is on that facility's page here.

Is it rude to ask a facility about its violations?

No, and the reaction is itself information. Every facility of any size has findings on its record; an administrator who knows theirs, can say what was corrected and when, and does not appear surprised is telling you something real about how the building is run.

How many nursing homes near Houston have serious citations?

Of the 29 Medicare-certified nursing homes published on this site, 19 have at least one citation CMS graded at immediate jeopardy — its finding that a failure caused, or was likely to cause, serious injury, harm or death. Citations reflect the survey date and may since have been corrected.

Start here: nursing homes · assisted living · what the A–L inspection codes mean

Other guides

• Type A vs Type B assisted living in Texas

  What the two Texas licences permit, and why the difference is about evacuation rather than comfort or price.

• What a Texas memory care certification is

  Texas certifies memory care separately from the assisted living licence. How to check a facility holds one.

• What Medicare pays for in a nursing home

  Medicare does not pay for long-term care. What the skilled nursing benefit covers, and the observation-status trap.