Does anyone know how administrators at nursing homes decide on the products that they buy?

Nursing homes and ALs have offsight pharmacies they have contracts with. Durable equipment is usually ordered thru Medicare or Medicaid for the residents. I would guess they have equipment suppliers they do business with that work with Medicare and Medicaid.

Facilities usually negotiate with the wholesale divisions of Medline, McKesson,etc., in the same manner hospitals negotiate purchase prices. The best contract terms normally win. Contract negotiations for everything, is typically handled by one person in corporate.