Finding a Nursing Homes for Stroke Patients: Step-By-Step


Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

A stroke can be a catastrophic event that leaves some people with permanent disabilities. The cause and severity of the stroke can determine whether symptoms will be significant, temporary, or permanent. Unfortunately, the consequences of a stroke can impact a person’s ability to take care of themselves safely, and you may need to consider long term stroke care.

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A massive stroke can cause complications such as difficulty swallowing, talking, memory problems, poor balance, and emotional outbursts. After someone is hospitalized for a stroke, they receive treatment and usually go to skilled nursing for continued rehabilitation. 

Since skilled nursing is time-limited based on insurance criteria and progress, sometimes a patient doesn’t recover sufficiently to go home. The patient may be referred to a long-term care nursing home in those cases to continue recovery.

If your loved one cannot return home, you may have to choose the best nursing home that can continue to offer treatment and rehabilitation. The task of finding a nursing home that can provide the best care could be a challenge, but we will show you how.

What Types of Nursing Homes Serve Stroke Patients?

To begin, what types of nursing homes specifically serve stroke patients? The short answer is that all types of nursing homes serve stroke patients. The main differences between nursing homes is in the details of the kind of rehabilitation they offer. Once you have exhausted your Medicare rehabilitation benefit, you would either have to pay for therapy services at a nursing home or participate in what the facility allows if you are on Medicaid.

The critical part of choosing a nursing home for your loved one who has had a stroke is finding the best comprehensive care. Nursing homes are equipped to handle complex medical needs, stroke being one of them. Most nursing homes already understand the needs of stroke survivors, and they can help you navigate this process. 

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What Should You Look for in a Nursing Home for a Loved One Who Had a Stroke?

Nursing home care has come under extraordinary scrutiny lately due to the pandemic. A disproportionate number of nursing home residents died from COVID 19. In investigating these deaths, long-standing issues in nursing homes emerged, including poor infection control, inadequate oversight, and high staff turnover.

Despite these challenges, you can find a nursing home for your loved one with a stroke. There is the possibility you won’t have much time, especially if a discharge is imminent. Work with the skilled nursing home discharge planner to narrow your search and look for these elements.

Determine what your loved one needs

To start, gather all of your loved one’s medical and discharge records from the hospital and skilled nursing. By reviewing those and talking with your loved one’s health care providers, you can prepare for the specific care your loved one requires. 

Even though you may not be in the medical field, you can ensure that care is delivered the way it should be. In many cases, you have to be your loved one’s advocate. 

Look for adequate and consistent staffing

Next, determining adequate staffing could be challenging since you have no way of verifying staff to resident ratio. Either way, it doesn’t hurt to ask, and if you can speak with one of the nurses or aides, you might get a more accurate picture.

Consistent staffing is important because learning your loved one’s disabilities, communication style, and preferences over time translates into better care. If different aides or nurses constantly rotate every week, the experience could be anxiety-provoking, and they may miss medical issues.

Consider rehabilitation services and equipment

Rehabilitation is vital to recovery and improvement. Even though your loved one may have finished skilled nursing, they may still benefit from continued therapy. Ask about rehabilitation services and, if possible, look at the therapy space. 

Outdated or limited equipment isn’t necessarily negative, but newer devices might better meet your loved one’s needs. Meet with therapy staff to determine what services your loved one can expect, how often, and for how long. 

Talk to staff about training

When working with someone who has a stroke, staff training is critical to meeting the unique needs of your loved one. For example, swallowing or communication could be an issue or paralysis that makes mobility challenging. Ask if there is a dedicated wing of the nursing home for stroke patients or a separate care protocol.

Look for inspection deficiencies

Since inspection deficiencies are hard to verify in nursing homes, do what you can to root out troubled facilities. Another promising avenue is to call the Ombudsman office to speak with an investigator about any allegations and complaints made against the nursing home you have in mind. 

The popular site Medicare Compare has been found to contain erroneous information due to nursing homes concealing deficiencies to Center for Medicare and Medicaid Services (CMS).

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How to Find a Nursing Home for a Loved One Who Had a Stroke

Finding a nursing home for a loved one who has had a stroke could be a challenge, but it’s worth the effort. The more time you take, the better, but devote a solid few hours to doing your homework if time is short.

Consider a non-profit nursing home

Not every non-profit nursing home will outperform a for-profit one, but many do. Since nonprofits are not beholden to shareholders, they return any profits back to the facility. 

Sometimes their staffing is also better since they are not cutting costs to increase profits for their shareholders. Many non-profit nursing homes are faith-based but accept patients regardless of religious affiliation. 

Talk to your loved one’s neurologist

Your family member likely has a neurologist following their care after a stroke. That person may have information about the best nursing homes for stroke care. Occasionally, a neurology department will have a social worker or nurse case manager to help you find the best placement.

Do an online search

An online search may reveal some nursing home nuggets worth exploring, but verify any claims of specialized stroke care. You might take in different reviews and case experiences. 


Visiting a nursing home can tell you quite a bit about care and cleanliness. Just because a facility is dated doesn’t mean they don’t provide excellent care. Just because a place looks new and shiny doesn’t mean they provide excellent care.

Try paying attention to cleanliness, staff behavior, and communication with patients themselves. If you can speak with a few of the residents, ask about the care they receive and what they like most and least about the nursing home.

Meet with the director of nursing and talk about other stroke patients in the facility and the kind of care they receive. If your loved one has special dietary needs, find out what that entails and if one-on-one support is available during meals.

Ask for a meeting with the director of nursing to determine specifics about stroke care. Come prepared with your loved one’s needs and ask detailed questions about how the staff approach stroke care.

Popular Alternatives to Nursing Homes for Stroke Survivors

An alternative to a nursing home for a stroke survivor depends on how much care a person needs. It is possible to pay for round-the-clock nursing and private duty care with enough money. But, that is a small percentage of people. Considering other alternatives is reasonable, and you may be able to take care of your loved one outside a nursing home.

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Long-Term Acute Care Hospital (LTACHs)

LTACHs are facilities for patients who need a high level of care but no longer need to be in the hospital and have complex needs that nursing homes can’t handle. A patient can stay at an LTACH for weeks or months, and some patients don’t recover to the extent that they can leave, but some do.

Assisted living facilities

Assisted living that offers a high level of care is possible when considering an alternative. Some assisted living communities offer end-of-life care where round-the-clock checks are possible- for a price. Assisted living might fall short if your loved one needs complex medical care such as a feeding tube, catheter care, or two people to transfer. 

Continued rehabilitation in assisted living is possible through Medicare-funded home health. Under the home health benefit, your loved one could have physical and occupational therapy for a limited time. Assisted living offers a wide range of services for someone who needs help, including dressing, bathing, and transferring. Basic amenities include meals, housekeeping, handicapped transportation to medical appointments, and activities.

An accessible home or apartment

Plenty of people who have strokes are cared for at home. The question is whether you have the resources and accessibility features to keep someone safe at home. You may need to evaluate who in the family has the time and ability to provide care and the status of their financial resources to hire private caregivers.

Contact a Certified Aging-in-Place Specialist (CAPS) or occupational therapist to assess the home environment and make recommendations. Remember that your loved one might worsen through time so put features in place to plan for that. 

Board and care 

Board and care, sometimes referred to as residential care, is an assisted living type residential home. The atmosphere is usually more intimate, and the individual attention to someone who has had a stroke can be reassuring. 

However, medical services could be limited, and home accessibility could be an issue. Overall, board and care would be more appropriate for someone who has had a stroke but is still somewhat independent. 

Hospice care

Hospice care, although end-of-life care, can be a significant support if your loved one has decided to give up active treatment. Hospice care can be provided at home, in assisted living, or other housing situations. Nursing, aides, chaplain, and social work services are all part of hospice care.

How to Find a Nursing Home for Stroke Patients

Recovery from a stroke can take a long time. Some people reach a plateau, and others continue to improve. If a nursing home is necessary, view it as an opportunity to support your loved one by choosing the best one you can and staying involved in their care. 

Finding the right nursing home is never easy, but it’s an important step as a family. Don’t be afraid to ask questions and take your time through this process. 


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