Finding the Right Nursing Home on Long Island: A Family Guide to Nassau and Suffolk County

When a parent or grandparent reaches the point where they need round-the-clock care, the search for a nursing home can feel overwhelming — especially on Long Island, where dozens of facilities are spread across two very different counties. Maybe you got the call from a hospital discharge planner. Maybe it was a slow realization over months of increasing falls, missed medications, or worsening dementia. Either way, you need answers, and you probably need them soon.

This guide is designed to help Long Island families navigate that process with a little less stress. We will walk through what is actually available in Nassau and Suffolk County, how to make sense of federal quality ratings, what to expect on costs and Medicaid, and how to narrow your options without spending weeks on the phone.

What the Long Island Nursing Home Landscape Looks Like

Long Island has roughly 70 to 80 skilled nursing facilities between Nassau and Suffolk County combined, which gives families a meaningful number of options — but also makes comparison harder. Nassau County alone has over 30 nursing homes, clustered in towns like Freeport, Uniondale, Plainview, and the south shore communities. Suffolk County has around 40, stretching from Smithtown and Huntington in the west out to Greenport and the Hamptons on the east end.

The two counties feel quite different when you are touring facilities. Nassau tends to have older, more established homes — some dating back to the 1960s and 70s — in denser suburban settings. Suffolk has a wider geographic spread, which means drive times between facilities can be significant, especially if you are comparing a place in Babylon to one in Riverhead.

One thing both counties share: capacity can be tight. Long Island's aging population is growing, and facilities with strong reputations often maintain waitlists. If you have any flexibility on timing, it is worth starting your search before a crisis forces a rushed decision.

How CMS Star Ratings Can Help (and Where They Fall Short)

Every Medicare-certified nursing home in the United States gets rated by the Centers for Medicare and Medicaid Services on a 1-to-5 star scale. You will see an overall rating plus three sub-ratings for health inspections, staffing, and quality measures. These ratings are public, updated regularly, and they are the closest thing to an objective baseline that exists for comparing facilities.

Here is how to use them without over-relying on them.

The health inspection rating is based on the last three years of state survey results. A facility with a 1-star inspection rating has had more deficiencies — and often more serious ones — than a 5-star facility. This is probably the most meaningful single number, because it reflects what trained surveyors actually observed on-site.

The staffing rating measures hours of nursing care per resident per day. More staff generally means more attention for each resident. But context matters here. A facility that specializes in short-term rehabilitation after surgery may have higher staffing ratios than a long-term care facility, and that does not necessarily mean the long-term care facility is worse — it may just serve a different population.

The quality measures rating looks at clinical outcomes like fall rates, pressure ulcers, and use of antipsychotic medications. These numbers are useful as a screening tool, but they can be influenced by the complexity of a facility's patient population. A home that accepts more medically complex residents may have outcomes that look worse on paper even if the care itself is strong.

The takeaway: use the stars to create a shortlist, not to make a final decision. A 5-star facility might still be the wrong fit if it does not offer memory care and your parent has Alzheimer's. A 3-star facility with a dedicated dementia unit and a compassionate staff might be exactly right.

You can compare CMS ratings for every nursing home in Nassau and Suffolk County side-by-side on CareNav's Long Island page.

What to Look for Beyond the Ratings

Ratings tell you something. A visit tells you a lot more.

When you walk into a facility, pay attention to the things that do not show up in any database. Is the building clean? Does it smell like cleaning products covering something up, or does it genuinely feel maintained? Are residents sitting in the hallways with nothing to do, or are there activities happening? Do the staff members acknowledge you, or do they avoid eye contact?

Talk to the admissions coordinator, but also try to talk to a nurse or aide on the floor. Ask them how long they have worked there. High turnover among direct care staff is one of the most reliable warning signs, and it is something CMS staffing data cannot fully capture because those numbers are self-reported.

A few specific things worth asking about during a tour:

How does the facility handle falls? What happens if a resident has a medical emergency at 2 AM — is there a physician on call, or does the resident get sent to the ER? What is the process for communicating with families about changes in condition? Can you see a sample activities calendar? How are dietary needs and preferences handled?

If the facility has a dedicated rehabilitation wing, ask about the therapy schedule. Some places offer therapy seven days a week. Others only go five days, which can slow recovery after a hip replacement or stroke.

For families exploring options in Nassau County, you can browse nursing homes by town to find facilities near you. Suffolk County families can do the same at the Suffolk County page.

Understanding Costs on Long Island

There is no easy way to say this: nursing home care on Long Island is expensive. Average daily rates in the Long Island region run in the range of $370 to $420 per day for a semi-private room, which translates to roughly $135,000 to $155,000 per year. Private rooms cost more. These numbers put Long Island well above the national average and above many other parts of New York State.

A few factors drive those costs. Real estate on the Island is expensive, which affects what facilities pay in property costs and taxes. Labor costs are high — certified nursing aides and licensed practical nurses in the metro New York area command higher wages than in most of the country. And the regulatory environment in New York is among the most stringent, which adds compliance costs that get passed through.

For families paying out of pocket, these numbers can feel staggering. The typical nursing home stay in New York runs about two and a half years on average, which means total costs can easily reach $350,000 or more.

Most families eventually look at Medicaid, which covers the full cost of nursing home care for eligible individuals. But qualifying is not straightforward. New York's Medicaid program has both income and asset limits, and there is a five-year lookback period for asset transfers. That means if your parent transferred assets — including gifting money to children or grandchildren — within five years of applying, there could be a penalty period where Medicaid will not pay.

This is where an elder law attorney becomes essential, not optional. A good elder law attorney on Long Island can help structure a Medicaid application, protect a spouse's assets through community spouse protections, and navigate the sometimes labyrinthine county Medicaid office process. Nassau and Suffolk each have their own Department of Social Services handling Medicaid applications, and the experience can differ significantly between the two.

If Medicaid planning is relevant to your situation, start the conversation with an attorney as early as possible — ideally months before a nursing home admission, not after.

Short-Term Rehab vs. Long-Term Placement

Not every nursing home stay is permanent. In fact, a large percentage of admissions on Long Island are for short-term rehabilitation — typically after a hospital stay for surgery, a fracture, a stroke, or a cardiac event. Medicare covers the first 20 days of a skilled nursing stay at 100 percent (after a qualifying hospital stay), and days 21 through 100 at a reduced rate with a daily copay.

If your family member needs short-term rehab, the priorities are a little different than for a long-term placement. You want a facility with strong therapy programs — look for places that offer physical, occupational, and speech therapy, ideally six or seven days a week rather than just Monday through Friday. Ask about the therapy gym: is it well-equipped, or does it look like an afterthought?

Also ask about the discharge planning process before admission. A good rehab facility starts thinking about the transition home from day one. That means coordinating home health services, equipment like walkers or hospital beds, and follow-up appointments. If the facility seems vague about discharge planning during the admissions conversation, that is worth noting.

For long-term placements, the calculus shifts toward quality of life. Activities, dining, the physical environment, and the warmth of the staff matter more when someone is going to live there for months or years. Ask to visit during an evening or weekend, not just during peak hours when everyone is on their best behavior.

Memory Care on Long Island

If your family member has Alzheimer's disease or another form of dementia, you will want to specifically ask whether a facility has a dedicated memory care unit. Not all nursing homes do. A dedicated unit typically means a secured area (so residents cannot wander out of the building), staff with specialized training in dementia care, and programming designed for cognitive engagement rather than general recreation.

Some Long Island facilities have excellent memory care programs. Others technically accept dementia patients but do not have the specialized infrastructure to support them well. This is a critical distinction, and it is not always obvious from a website or even from CMS data. You really need to visit the unit, meet the staff, and ask pointed questions about how they handle behavioral symptoms like agitation, sundowning, and wandering.

How to Narrow Your Search

With 70-plus options across two counties, you need a way to filter. Here is a practical approach:

Start with geography. How far are you or other family members willing to drive for regular visits? Consistent family presence makes a real difference in the quality of care a resident receives — facilities know which families show up regularly, and it matters. Be realistic about what a manageable drive looks like, especially in Long Island traffic.

Next, filter by the type of care needed. If your parent needs memory care, that immediately eliminates facilities without a dedicated unit. If they need dialysis, ventilator care, or other specialized medical services, the list narrows further.

Then look at CMS ratings to screen out facilities with serious inspection problems. You do not necessarily need to limit yourself to 4- and 5-star homes, but a facility with a 1-star health inspection rating deserves real scrutiny before you consider it.

Finally, visit your top three to five choices in person. No website, database, or guide — including this one — can replace walking through a building and getting a feel for the culture. Bring a list of questions, but also trust your instincts. If something feels off, it probably is.

Start Comparing Facilities

The nursing home search is rarely easy, but it does not have to be a shot in the dark. Between federal CMS data, public reviews from other families, and your own firsthand visits, you can make an informed decision that balances medical needs, geography, cost, and quality of life.

CareNav pulls together CMS ratings, Google reviews, and AI-powered summaries for every nursing home in Nassau and Suffolk County — all in one place, so you can compare without juggling ten browser tabs. You can search by ZIP code, browse Nassau County facilities, or explore Suffolk County options.