Nursing Home Checklist

Directions: This checklist is intended for use when selecting a nursing home or skilled nursing facility. Complete this for each facility you visit to keep track of and compare different facilities.

Name of Nursing Home:

Date of Visit:

Address:

Phone Number:

Contact:

Basic Information Yes No Comments
Is facility Medicare-certified?
Is facility Medicaid-certified?
Is the valid license posted?
Is the latest state survey or inspection report available for review?
Has the facility corrected all deficiencies (failure to meet a federal or state requirement) on its last inspection report?
Has the license ever been revoked? If so, why?
Is there a waiting period for admission?
Is the level of care (e.g., skilled, custodial) needed offered and a bed is available?
Are special services (e.g., dementia, ventilator, rehabilitation) needed offered in a separate unit and a bed is available?
Is facility located close enough to friends and family?
Financial and Legal Contract Yes No Comments
What is the base monthly fee?

$

What services are included in that fee?

$

If care is covered by Medicare, what are the out of pocket costs?

$

Is a deposit required?
Are payment plans available?
What are the additional services available and at what costs?

$

What is the procedure for when fees are changed? Who is notified?
If resident is hospitalized or placed in other care, how long will his or her bed held? At what fees or charges?
If the resident leaves the facility, are the advanced payments returned?
What are the reasons for discharge? How much notice is given and to whom?
Is there an internal appeal and/or grievance process? Are issues handled in a timely manner?
What are the eviction procedures?
Does the facility offer a separate insurance policy that covers residents' personal property?
Who is responsible for repairs or replacement after spills or accidents that destroy either the facility or resident's property?
Personal and Health Care Yes No Comments
Are residents encouraged to be as independent as possible?
Are residents allowed to make choices about their daily routine?
Are assessments performed on residents to assess needs? How often?
Can the facility accommodate with a resident's changing needs?
Does facility have the ability to determine the cause of confusion a resident may develop (medications versus diagnosis of dementia or Alzheimers')?
Does the facility have the ability to deal with a resident's behavior that may change and become abusive?
Are there any limitations on how the staff will handle your loved one's medications?
Are there safeguards in place to ensure that medications are taken on time and in the correct dosage?
Is a pharmacist available for individuals and staff?
Are routine and emergency drugs available? How are prescriptions filled? What are the costs?
Who dispenses medications?
Who reviews medication procedures and how frequently?
Do residents receive preventative care such as yearly flu shots?
Does the facility monitor residents' health including routinely monitoring weight?
Does the staff routinely check each resident thoroughly from head to toe to avoid bed sores?
May residents still see their own doctors?
How will physician and facility communicate about resident's care?
Are there health care facilities available at the facility (physical therapy, occupational therapy, wound care, hospice care, social services, etc.)?
Are there a variety of medical services available (dentists, podiatrists, optometrists)?
Will the staff set up appointments for residents?
Does the staff respond quickly when residents push the call buttons?
Does the facility have an arrangement with a nearby hospital for emergencies?
Does the facility call family or a personal doctor when emergencies arise? Under what circumstances?
Does the facility use physical or chemical restraints? If so, under what circumstances and policy?
Is there a beauty parlor or barber?
Are there laundry services? Is there an extra cost?
Plan of Care Yes No Comments
Does the facility prepare a written plan for how it will care for my loved one?
Are Certified Nursing Assistants involved in care planning meetings?
Are care plan meetings are held with residents and family at convenient times if possible?
How will my family be involved in the plan?
What if I don't agree with the plan?
What involvement does a confused resident have?
Does the plan cover all aspect of a resident's life? (physical, mental, social and medical)
Is the plan and any medical records stored? If so, is confidentiality guaranteed?
Does a pharmacist review individual drug treatment plans?
Residents Yes No Comments
Are residents clean, appropriately dressed for the season or time of day and well groomed?
Are residents interacting with each other? Do they look content and engaged?
What is the average age of the residents? Age:

 

What do residents like best? Least?
What is daily life like at the facility?
Are most residents at the same level of mental function as your family member?
Is there a resident and/or family council? How often does it meet? Has the council taken any action recently?
Are residents' rights posted? Does the facility follow a resident's bill of rights?
Do residents have the right to come and go as they please?
Is mail delivered promptly and unopened? Can residents have subscriptions to magazines and/or newspapers?
Environment Yes No Comments
Are there any overwhelming unpleasant odors?
Is the facility clean and well-kept?
Is the temperature comfortable for residents?
Is facility well lit?
Are there quiet and/or private areas for visiting with friends and family?
Are noise levels in common areas comfortable?
Is smoking not allowed or is it restricted to certain sections of the facility?
Are furnishings comfortable, sturdy and attractive?
Are the building and grounds well cared for and attractive?
Staff Yes No Comments
Is the staff visible?
Does the staff wear name tags?
Does the relationship between staff and residents appear to be polite, warm and respectful?
Are the staff friendly, considerate and helpful?
If residents or staff are not native English speakers, can they communicate effectively with each other?
Is the staff's morale upbeat and positive?
Does the staff refer to residents by name and knock before entering a resident's room?
Is training and continuing education programs available to all staff? What are trainer's qualifications?
Does the staff receive abuse prevention training?
Are background checks completed for all staff?
Does your guide providing the tour know residents' names and is recognized by residents?
Is there at least one full-time registered nurse (RN) on duty around the clock in addition to the Administrator or Director of Nursing?
Who is Director of Nursing?
Does he or she hold a current state license?
Is the administrator or Director of Nursing available to answer questions, hear complaints, or discuss problems and concerns?
Does the same team of nurses work with same residents most days of the week?
How long are shifts? Hours:

 

Is the ratio of Certified Nursing Assistants to residents is reasonable? How many during the day? At night? On weekends?
Is the ratio of aides to residents reasonable? How many during the day? At night? On weekends?
Are the staff expected to handle emergencies? How are they trained?
Is there at least one full-time social workers is on staff? What services does he/she provide?
Is a licensed doctor is on staff, on site daily and can be reached at all times? What hospital is he or she affiliated with?
Has the management team worked together for at least one year?
Residents' Room Yes No Comments
Is the living space big enough?
Is it well lit?
How often is the room cleaned?
Can residents have personal belongings and/or furniture in their rooms?
Does each resident have storage space in his or her own room?
Is there a window in each resident's room?
Do residents have access to a personal telephone, Internet and television?
Is there a cable TV connection in each room?
Are doors shut when a resident is being dressed or bathed?
Are water pitchers within a resident's reach?
Do policies and procedures exist to protect residents' possessions?
Are call buttons near each bed or do residents wear a device instead?
Is there a private bathroom? If so, how often is it cleaned?
Is there a call button in the bathroom?
Are the rooms private or shared? If shared, do residents have a choice of roommates?
How many roommates to a room?

#:

Is there a privacy curtain around each bed or between beds?
What is policy if roommates are not getting along with each other? How does facility deal with problems when they arise?
Menus and Food Yes No Comments
Do residents have a choice of food items at each meal?
Is there enough time to eat meals?
Are favorite foods offered?
Does the food look and smell good?
Are special dietary needs accommodated? How?
Are nutritious snacks available upon request?
Can staff help residents eat and drink at mealtimes if needed?
Is the meal schedule flexible? At what times are meals served?
Does a nutritionist or dietician review meals and special diets?
Can a meal tray be delivered to a resident's room? At what cost?
Is the food preparation separated from the dishwashing and garbage areas?
Is food requiring refrigeration properly stored?
Do the kitchen workers observe sanitation rules?
Activities Yes No Comments
Are residents, including those who are unable to leave their rooms, able to choose to take part in activities? Are residents encouraged, not pushed, to participate?
Are activity schedules varied and include resident's interests? Do residents provide input?
Is there someone who develops and supervises recreational activities? What is their background?
Is reading assistance available?
Does the facility have pleasant outdoor areas for resident use? Does the staff help residents go outside?
Are there protected/enclosed areas for residents with dementia?
Are residents involved in the community outside the facility? If so, how? How is staff involved?
Are there recreation facilities on site (such as a game room)?
Can residents exercise? What are the exercise facilities like?
Does the facility have an active volunteer program? Are volunteers from the community? Are they screened?
What is the visiting policy?
Does the facility have pets? Or can family pets come with visitors? If yes, what are the restrictions?
How does the facility accommodate religious or spiritual needs?
Safety and Security Yes No Comments
Is there a security checkpoint at the entrance?
Does the facility meet local, state and federal fire codes?
Are emergency exits clearly marked, accessible and easily opened from the inside?
Are there fire safety systems? (For example, smoke detectors, fire extinguishers and sprinklers are in each room.)
Is there an emergency evacuation plan? Is it posted?
Does the facility hold regular fire drills that include bed-bound residents?
Are the facility's doors locked? When? How does a resident or family member get into the home when the doors are locked? Are exit doors alarmed?
Are there safety locks on windows?
Are there handrails in the hallways and grab bars in the bathrooms?
Are stairway doors kept closed to prevent potential spread of fire?
Is the facility wheelchair accessible? (Example: hallways are wide enough, there are wheelchair ramps)
Is floor covering made of nonskid material?
Is the building generally free of clutter?
Are there safety measures in place to protect residents from wandering?
Is there an emergency generator or alternate power source?
Are there written policies about when 911 is called and who decides to call?
Transportation Yes No Comments
How does the facility handle transportation for appointments?
What are the costs involved in using their transportation?

$

Is transportation wheelchair accessible?
Is transportation available for non-medical appointments?
Is there parking available?
Is there public transportation nearby?
General rating on a scale of 1 (poor) to 5 (excellent):

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