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Visit often, and not just pop in visits. Stay for a few hours and watch the interactions, not only with your LO but with other residents too. I am there 4 hours/day, but not everyone can do that. When you do visit, some things to look for: is the room clean and bed made? Is s/he well dressed and clean, face washed, teeth clean, nails clean, hair tidy? Is the laundry put away? Is the activity calendar posted in the room where it’s readable. Is the dining and common room clean? Are there bad smells? Look at the latest state inspection report which should be displayed on each floor. What are the comments? Is the nursing station accessible and the nurses approachable? If the facility has a monthly Family Council meeting plan to attend. How often are the care plan meetings? How do they ensure the social worker, dietitian, Nurse Manager, therapists and family all on the same page regarding the plan? How do the shifts communicate? What’s the ratio of CNAs to residents on each shift? Moms floor runs pretty smoothly with 5 CNAs to 38 residents, just as an example. These are just some thoughts from my experience.
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Jtalley, if you live close enough to the skilled nursing facility, be present on a regular basis. Get to know the nurses and the aides. Then you can view how your love one and other patients in the facility are being cared for. Try not to question the nurses and aides on how they are doing things, from years of experience and caring for hundreds of patients they pretty much know what works best.

Just remember your love one won't be having one on one care 24/7, like hiring a private caregiver. The facility should make sure the patient is clean, well fed, and comfortable.

Just go by your gut feeling. If something is amiss, talk to the nurse. If she cannot correct the situation, then find the head/charge nurse. Then work up the chain if you feel you aren't getting the right answers.
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Visit. Visit. VISIT!!! Get to know the director and the aides helping your loved one.
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