This study focuses on optimizing the lighting environment in nursing homes, aiming to address the prevalent issues of expert-biased subjective weighting and the lack of user experience data in current lighting design practices. A comprehensive evaluation system consisting of 15 lighting-related sub-indicators (B1–B15) was established, and three representative institutions-Beijing No.1 Social Welfare Institute, Hangzhou Gangguquan Nursing Home, and Guangzhou Yuetree Health Center-were selected as case study sites. Through questionnaire surveys and on-site data collection, a user rating matrix was constructed. The Analytic Hierarchy Process (AHP) was applied at the expert level, while the CRITIC method was employed at the user level to calculate respective weights for each indicator. These were then integrated to produce a set of comprehensive weights. The results show that “Illuminance Appropriateness (B1)” received the highest comprehensive weight (0.1653), followed by “Integration of Green Building Materials and Lighting Design (B15, 0.1177),” “Smart Lighting Control System (B14, 0.1060),” and “Lighting Suitability by Functional Zone (B5, 0.1072).” In contrast, “Support for Circadian Rhythms (B4, 0.0452)” and “Emergency Lighting System Completeness (B7, 0.0372)” were rated with lower weights. Based on these findings, the study proposes specific improvements, including setting a baseline illuminance standard of 300–500 lx, combining natural lighting with high-reflectivity eco-friendly materials, introducing intelligent DALI/ZigBee control platforms, and managing color temperature by zones. The study lays a theoretical foundation for incorporating physiological monitoring data and seasonal demand variations into future lighting evaluation systems, offering both theoretical insights and practical implications.