Choosing a nursing home is one of the most important decisions you will make for yourself or a family member. The right facility can make the difference between a fulfilling, comfortable life and years of frustration. With over 2,600 residential aged care homes across Australia, the choice can feel overwhelming.

This 15-point checklist gives you a structured, practical way to evaluate nursing homes. Use it to compare facilities, ask the right questions, and make a confident decision.

Key Points

  • Australia’s Star Ratings system scores nursing homes across four categories: residents’ experience, compliance, staffing, and quality measures
  • Visit facilities at least twice, including once unannounced, to see daily operations in real conditions
  • The basic daily fee is approximately $63.82 per day (2025 rate), with additional means-tested fees based on your income and assets
  • Staffing targets require 215 minutes of care per resident per day, with 44 minutes from a registered nurse
  • You can trial a facility through respite care for up to 63 days per year before committing
  • Your ACAT approval is portable, so you can change nursing homes at any time if you are not satisfied

Why Your Choice Matters

The nursing home you choose will become someone’s home, potentially for years. Quality varies significantly between facilities. The Royal Commission into Aged Care Quality and Safety found widespread problems with care quality, staffing, and oversight across the sector. While reforms have improved standards, the responsibility still falls on families to do thorough research.

A structured approach protects against rushed decisions made during hospital discharge or crisis situations. Taking time to evaluate facilities against clear criteria leads to better outcomes.

1. Check Star Ratings

The Australian Government’s Star Ratings system is your starting point for comparing nursing homes. Every residential aged care facility receives an overall star rating plus individual ratings across four categories.

The four rating categories:

CategoryWhat It Measures
Residents’ ExperienceSatisfaction surveys from current residents
ComplianceHistory of meeting Aged Care Quality Standards
StaffingCare minutes delivered per resident per day
Quality MeasuresClinical indicators like pressure injuries, falls, and medication management

A facility needs strong performance across all four categories, not just an impressive overall score. A home with five stars for staffing but two stars for compliance may have systemic management problems.

Where to check: Visit the My Aged Care website or the Aged Care Quality and Safety Commission to view ratings for any facility in Australia.

For a deeper look at what these standards mean in practice, read our guide to nursing home quality standards in Australia.

2. Review Staffing Levels

Staffing is the single biggest factor in care quality. The Australian Government has set care minute targets that all residential aged care facilities must meet.

Current staffing targets:

  • 215 minutes of total care per resident per day (from registered nurses, enrolled nurses, and personal care workers combined)
  • 44 minutes of registered nurse care per resident per day
  • A registered nurse must be on site 24 hours a day, 7 days a week

Facilities that exceed both targets by 110% or more achieve a 5-star staffing rating. Those falling below 90% on either measure may receive just 1 star.

Questions to ask the facility:

  • What is your current staff-to-resident ratio during the day? At night?
  • How many registered nurses are on duty at any given time?
  • What is your staff turnover rate?
  • Do you use agency staff regularly, or is your workforce mostly permanent?

High staff turnover is a red flag. Consistent staff build relationships with residents, understand their preferences, and notice subtle changes in health. Facilities relying heavily on agency workers may struggle to provide personalised care.

3. Visit at Different Times

A single scheduled tour gives you the facility’s best presentation. To understand what daily life actually looks like, visit at least twice and at different times.

Recommended visit schedule:

  • First visit: Scheduled tour during business hours (see the facility’s prepared presentation)
  • Second visit: Unannounced, during a meal time (observe real daily routines)
  • Third visit (if possible): Weekend or evening (see staffing levels outside peak hours)

During each visit, pay attention to how staff interact with residents. Are they patient and respectful? Do they knock before entering rooms? Are residents engaged or sitting idle? Does the atmosphere feel calm or chaotic?

Our detailed guide on what to look for during nursing home tours covers specific observations to make during each visit.

4. Understand All Costs

Nursing home costs in Australia involve multiple fee components. Understanding these before you commit prevents financial surprises.

Fee structure overview:

Fee TypeAmount (2025)Who Pays
Basic Daily Fee$63.82/day ($23,294/year)All residents
Means-Tested Care FeeVaries (annual cap: $34,311)Based on income and assets assessment
Accommodation Payment (RAD/DAP)Varies by facility and roomResidents with assets above threshold
Extra ServicesVariesOptional, agreed by resident

The basic daily fee is set at 85% of the single basic Age Pension and is indexed twice per year. Everyone pays this fee regardless of their financial situation.

The means-tested care fee depends on your income and assets. If your income is below $34,762 and assets below $63,000, the government covers your full accommodation costs. There are annual and lifetime caps on means-tested fees to protect residents from excessive charges.

Residents entering care from 1 November 2025 may be subject to a new fee structure that includes hotelling contributions and non-clinical care contributions. Check the Department of Health website for the latest fee arrangements.

Questions to ask about costs:

  • What is included in the basic daily fee?
  • What additional charges apply for extras like hairdressing, outings, or podiatry?
  • How is the accommodation payment structured (lump sum RAD, daily DAP, or combination)?
  • Are there any exit fees or refund policies?

For a full breakdown of all nursing home costs, see our complete guide to nursing home costs in Australia.

5. Assess the Food Quality

Meals are a major part of daily life in residential care. Poor food quality affects nutrition, health, and overall wellbeing. The Royal Commission highlighted food as a consistent area of concern across the sector.

What to evaluate:

  • Menu variety: Ask to see a full week’s menu. Look for variety, fresh ingredients, and options for different dietary needs
  • Meal timing: Are meals served at reasonable times? Is there flexibility for residents who prefer to eat earlier or later?
  • Snacks and hydration: Are drinks and snacks available between meals?
  • Special diets: How does the facility accommodate allergies, cultural dietary requirements, texture-modified diets, and personal preferences?
  • Dining experience: Is the dining area pleasant? Can residents eat in their rooms if they prefer?

During your visit: Try to observe a meal service. Watch whether staff assist residents who need help eating. Check whether food looks appetising and is served at the right temperature. Ask residents what they think of the food.

6. Evaluate Activities

A good nursing home offers more than just clinical care. Meaningful activities support mental health, social connection, and physical function.

Look for a program that includes:

  • Physical activities (gentle exercise classes, walking groups, gardening)
  • Social activities (group games, morning teas, movie nights)
  • Creative activities (art, music, craft)
  • Cognitive activities (quizzes, reading groups, puzzles)
  • Cultural and spiritual activities (religious services, cultural celebrations)
  • Individual activities for residents who prefer one-on-one engagement
  • Community outings and excursions

Check the activity calendar. Is it displayed publicly? Does it show a genuine variety of options, or is it the same few activities repeated? Are activities available on weekends, or only during weekday business hours?

Ask whether activities are tailored to individual interests and abilities. A resident who loved gardening before entering care should have access to a garden or planter boxes. Someone who enjoyed music should have opportunities to listen to or play music.

7. Inspect the Physical Environment

The building and grounds tell you a lot about how a facility is managed. Walk through every area you can access, not just the show rooms.

Environmental checklist:

  • Cleanliness: Are floors, bathrooms, and common areas clean? Is there a persistent odour (strong air freshener can mask poor hygiene practices)?
  • Safety: Are handrails in corridors and bathrooms? Are floors non-slip? Are emergency call buttons accessible from beds, chairs, and bathrooms?
  • Lighting: Is the facility well-lit, including corridors and outdoor areas?
  • Temperature: Is the building comfortable? Is heating and cooling adequate?
  • Outdoor spaces: Are there accessible gardens or courtyard areas? Can residents go outside independently if they are able?
  • Room size: Are rooms large enough for personal furniture and belongings? Do rooms have adequate storage?
  • Bathrooms: Are ensuite bathrooms available? Are they wheelchair accessible?
  • Common areas: Are lounges, dining rooms, and activity spaces comfortable and inviting?

Pay attention to maintenance. Peeling paint, broken fixtures, and worn carpets suggest the facility may be cutting corners on upkeep, which can extend to care quality.

8. Check Dementia Care

If your family member has dementia or is at risk of developing it, the facility’s approach to dementia care is critical. Not all nursing homes offer specialised dementia support, and quality varies greatly among those that do.

Key questions for dementia care:

  • Does the facility have a dedicated dementia or memory support unit?
  • Is the unit designed for safety (secure access, clear wayfinding, reduced confusion triggers)?
  • What dementia-specific training do staff receive?
  • How does the facility manage behavioural symptoms without excessive medication?
  • Are there dementia-specific activities (reminiscence therapy, sensory activities, music therapy)?
  • How does the facility handle wandering behaviour?
  • What is the approach to restraint (physical and chemical)?

Look for signs of good dementia care: Clear signage with pictures and words, colour-coded corridors, visible clocks and calendars, calm and quiet spaces, and staff who engage patiently with confused residents.

Ask about the facility’s restraint policy. The use of physical or chemical restraint should be a last resort, well documented, and regularly reviewed. Facilities that rely heavily on sedating medications to manage behaviour may not be providing adequate dementia care.

9. Review Complaints History

Every aged care facility’s complaints history is publicly available through the Aged Care Quality and Safety Commission. This record reveals patterns that a single visit might not uncover.

How to check:

  1. Visit the ACQSC website
  2. Search for the facility by name or location
  3. Review any compliance notices, sanctions, or non-compliance findings

What to look for:

  • Frequency of complaints: Occasional complaints are normal. A pattern of repeated complaints in the same area (such as staffing, medication management, or dignity of care) indicates a systemic problem
  • Sanctions or notices: These are serious regulatory actions that indicate the facility has failed to meet quality standards
  • Response to complaints: Has the facility addressed past issues effectively? Are the same problems recurring?

Also ask the facility directly how they handle complaints. A good facility will have a clear, accessible complaints process and will welcome feedback rather than becoming defensive.

10. Understand the Contract

Before signing any agreement, read every document carefully. Residential aged care contracts can be complex, and the terms affect your rights and financial obligations for years.

Key documents to review:

  • Resident Agreement: Covers care services, fees, rights, and responsibilities
  • Accommodation Agreement: Details your accommodation payment (RAD, DAP, or combination), room allocation, and refund conditions
  • Extra Services Agreement: Lists any additional services and their costs

Watch for these contract details:

  • Notice period requirements (how much notice you must give to leave, and how much notice the facility must give you)
  • Fee increase provisions (how and when fees can be raised)
  • Refund policies for accommodation deposits
  • What happens if the resident’s care needs change significantly
  • Room transfer policies (can the facility move you to a different room?)

Consider having the contract reviewed by a financial adviser or solicitor who specialises in aged care before signing. The Older Persons Advocacy Network (OPAN) on 1800 700 600 also provides free advice.

11. Assess Medical and Clinical Care

The quality of clinical care determines whether residents receive appropriate treatment for health conditions, pain management, and preventive care.

Clinical care questions:

  • How does the facility manage medications? Is there a pharmacist review process?
  • What happens in a medical emergency? Is there an after-hours doctor on call?
  • How are GPs involved? Can residents keep their own GP, or must they use the facility’s doctor?
  • What allied health services are available on site (physiotherapy, occupational therapy, speech pathology, podiatry)?
  • How does the facility manage pain, particularly for residents who cannot communicate their pain levels?
  • What infection control procedures are in place?
  • How are falls prevented and managed?

Check whether the facility has regular visits from allied health professionals or whether residents need to arrange these independently. Access to physiotherapy, in particular, plays a significant role in maintaining mobility and independence.

12. Talk to Current Residents and Families

The most honest assessment of a nursing home comes from the people who live there and the families who visit regularly.

How to gather feedback:

  • During your visit, ask residents if they are happy with the care they receive
  • Speak with family members in common areas or the car park
  • Ask the facility if they have a residents’ and families’ committee you can speak with
  • Check online reviews, but weigh them against your own observations (both overly positive and overly negative reviews may not reflect the typical experience)

Questions to ask residents and families:

  • Do staff respond quickly when you press the call button?
  • Are you satisfied with the food?
  • Do you feel safe here?
  • Have you ever had a complaint? How was it handled?
  • Would you recommend this facility to a friend?

Listen carefully to what people say and what they avoid saying. Hesitation or vague answers can be just as telling as direct criticism.

13. Consider Location

Location affects how often family and friends can visit, which directly impacts a resident’s wellbeing and quality of life. Regular visits from loved ones improve mental health, provide an extra layer of oversight, and help residents feel connected.

Location factors to weigh:

  • Proximity to family: How far is the facility from the people who will visit most often? A facility 10 minutes away will get far more visits than one 90 minutes away
  • Public transport: Can visitors who do not drive reach the facility easily?
  • Parking: Is there adequate free parking for visitors?
  • Local amenities: Are there shops, cafes, or parks nearby for outings?
  • Hospital proximity: How close is the nearest hospital for emergency transfers?
  • Familiar neighbourhood: Is the facility in an area the resident knows? Familiar surroundings can be comforting, particularly for people with dementia

Choosing a facility close to family is almost always worth prioritising, even if it means compromising on other factors. The benefits of frequent, regular visits outweigh many facility features.

14. Try Respite Care First

If time allows, a respite stay is the best way to experience a facility before making a permanent commitment. Respite care provides temporary residential care for up to 63 days per year.

Benefits of a trial respite stay:

  • Experience the daily routine, food, activities, and care firsthand
  • Observe staff interactions over multiple days rather than a single visit
  • Test whether the facility meets specific needs (mobility support, dietary requirements, social preferences)
  • Give the resident time to form an opinion based on real experience
  • Provide the family with peace of mind before a permanent move

How to arrange respite care:

  1. Contact My Aged Care on 1800 200 422 to request an assessment (if not already assessed)
  2. Receive ACAT approval for residential respite care
  3. Contact facilities directly to check respite bed availability
  4. Complete a short admission process

Respite care is also government-subsidised, making it an affordable way to trial a facility. Ask the facility about respite availability, as some homes have dedicated respite beds while others offer them only when permanent beds are vacant.

15. Ask About Lifestyle

Beyond clinical care and physical environment, the day-to-day lifestyle within a facility determines whether a resident feels at home or merely housed.

Lifestyle questions to ask:

  • Wake and sleep times: Can residents follow their own schedule, or must everyone conform to set times?
  • Meals: Can residents choose when and where they eat? Are snacks available outside meal times?
  • Visitors: What are the visiting hours? Are they flexible? Can family members join for meals?
  • Pets: Does the facility allow pet visits? Do they have resident animals?
  • Personal belongings: Can residents bring their own furniture, photos, and personal items to make their room feel like home?
  • Technology: Is Wi-Fi available? Can residents have their own TV and phone?
  • Alcohol and smoking: What are the policies on alcohol with meals or designated smoking areas?
  • Couples: If both partners need care, can they share a room?
  • Cultural and language needs: Does the facility cater to specific cultural or language communities?
  • Religious practice: Are religious services or spiritual care available?

A facility that supports individual choice and personal routines will feel more like a home and less like an institution.

Your Decision Checklist

Use this summary checklist when comparing facilities. Rate each facility on every point and compare your results.

Checklist ItemFacility AFacility BFacility C
1. Star ratings (overall and per category)
2. Staffing levels and stability
3. Impressions from multiple visits
4. Cost transparency and affordability
5. Food quality and variety
6. Activities and engagement
7. Physical environment and maintenance
8. Dementia care capability
9. Clean complaints history
10. Fair and clear contract
11. Medical and clinical care quality
12. Positive feedback from residents/families
13. Convenient location for visitors
14. Respite trial available
15. Lifestyle flexibility and choice

What to Do If You Are Not Happy

Choosing a nursing home is not a permanent, irreversible decision. Your ACAT approval is portable, meaning it applies to any approved residential aged care facility in Australia. You can transfer to a different facility at any time.

Steps to take if you have concerns:

  1. Raise the issue directly with the facility’s management
  2. Contact the facility’s complaints officer
  3. If the issue is not resolved, contact the Aged Care Quality and Safety Commission on 1800 951 822
  4. For independent advocacy support, call the Older Persons Advocacy Network (OPAN) on 1800 700 600
  5. Begin researching alternative facilities while your concerns are being addressed

You do not need to wait for a complaint to be resolved before starting the transfer process. Your right to choose your care provider is protected under the Charter of Aged Care Rights.

Key Resources

Frequently Asked Questions

How do I choose a good nursing home?

Check quality star ratings on the My Aged Care website, visit at different times of day, speak to current residents and their families, compare costs across facilities, review staffing ratios and turnover, and check the complaints history on the Aged Care Quality and Safety Commission website. Use respite care to trial your top choice before committing.

What should I look for when visiting a nursing home?

Observe cleanliness, staff interactions with residents, food quality during meal times, the range of activities offered, outdoor areas and gardens, safety features like handrails and call buttons, and the overall atmosphere. Talk to residents about their daily experience. Visit at least twice, including once unannounced.

How do I check nursing home quality ratings?

Visit the My Aged Care website or the Aged Care Quality and Safety Commission website. Star ratings cover four categories: staffing (care minutes per resident), compliance (meeting quality standards), quality measures (clinical indicators), and resident experience (satisfaction surveys).

Can I do a trial stay at a nursing home?

Yes. Respite care allows temporary stays of up to 63 days per year in a residential aged care facility. This is an excellent way to experience the daily routine, food, activities, and care quality before making a permanent decision. You need an ACAT assessment and approval for residential respite. Contact My Aged Care on 1800 200 422 to arrange an assessment.

What if I am unhappy with the nursing home?

You can change facilities at any time. Start by raising concerns with the facility’s management. If issues are not resolved, contact the Aged Care Quality and Safety Commission on 1800 951 822. For independent advocacy support, call OPAN on 1800 700 600. Your ACAT approval is portable to any approved facility in Australia, so you do not need a new assessment to transfer.

How much does a nursing home cost?

All residents pay a basic daily fee of approximately $63.82 per day (2025 rate), which is 85% of the single basic Age Pension. Additional means-tested care fees depend on your income and assets, with an annual cap of $34,311 and a lifetime cap of $82,347. Accommodation payments vary by facility and room type. Read our complete guide to nursing home costs for a full breakdown.

How long is the waiting list for nursing homes?

Waiting times vary significantly by location, facility, and room type. Metropolitan areas with high demand may have waiting lists of several months. Regional facilities may have shorter waits. Contact facilities directly to ask about current availability, and register your interest with multiple homes to improve your chances of a timely placement.

Find the Right Nursing Home

Choosing a nursing home takes time, research, and careful evaluation. This 15-point checklist gives you a framework to compare facilities fairly and make a decision based on evidence rather than pressure.

MD Home Care is a connection platform that helps families find and compare aged care services across Australia. Whether you need help identifying suitable facilities, understanding your options, or navigating the aged care system, we can connect you with the right support.

Explore our residential aged care services or browse our aged care resource hub for more guides and tools.

Call 1800 953 253 to find the right nursing home for your family through MD Home Care.