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Nursing Home Checklist

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First Impression

  • Do you like the facility's location and outward appearance?
  • Is the facility convenient for frequent visits by family and friends?
  • Are you welcomed with a warm greeting from the staff?
  • Does the staff address residents by their names and interact with them during your tour?
  • Do you notice the residents socializing with each other and do they appear content?
  • Can you talk with residents about how they like living there and about the staff?
  • Is the staff appropriately dressed, friendly and outgoing?
  • Do the staff members treat each other in a professional manner?
  • Are visits with the residents encouraged and welcome at any time?
  • What percentage of the rooms/beds is available?
  • Is there a waiting list? If so, how long do they estimate it will take to be admitted?
Living Area and Accommodations

  • Is the floor plan well designed and easy to follow?
  • Are doorways, hallways and rooms accommodating to wheelchairs and walkers?
  • Are elevators available for those unable to use stairways and handrails to aid in walking?
  • Are floors of a non-skid material and carpets conducive for safe walking?
  • Does the residence have good lighting, sprinklers and clearly marked exits?
  • Is the residence clean, free of odors and appropriately heated/cooled?
  • What is the facility's means of security if a resident wanders?
  • Are the common areas in general attractive, comfortable and clean?
  • Is there an outside courtyard or patio for residents and visitors, and assistance getting there?
  • Does the residence provide ample security and is there an emergency evacuation plan?
  • Are private rooms available and/or double occupancy units for sharing with another person?
  • Does residence have furnished/unfurnished rooms? What is provided or what can they bring?
  • May they decorate their own rooms? Is there adequate storage space?
  • Is a 24-hour emergency response system accessible from the unit?
  • Are bathrooms private with handicapped accommodations for wheelchairs and walkers?
  • Do all units have a telephone and cable TV and how is billing handled?
Moving In, Contracts, and Finances

  • What's involved with the moving in/out process? How is the initial needs assessment done?
  • Does assessment process include the resident, family, facility staff, along with the physician?
  • Is there a written plan for the care of each resident? Is there an ongoing process for assessing a resident's need for services and how often are those needs evaluated?
  • Is there a written statement available of the resident rights and responsibilities?
  • Is a contractual agreement available that clearly discloses healthcare, accommodations, personal care and supportive services, all fees, and admission and discharge provisions?
  • What type of insurance is required/accepted? Medicare/Medicaid/Medigap/Long-term care/Private?
  • What are the specific costs for various levels of care including skilled/unskilled beds?
  • What additional services and staff are available if the resident's needs change?
  • When may a contract be terminated and what are the policies for refunds and transfers? Is there an appeals process for dissatisfied residents?
  • What happens if funds are depleted and full payments can no longer be made?
  • Is there any government, private or corporate programs available to help cover the costs?
  • Is there a procedure to pay for additional services such as skilled nursing care when the services are needed on a temporary basis?
  • Do billing, payment and credit policies seem fair and reasonable? May resident handle his/her own finances with staff assistance if able? Must a family member/outside party be designated?
Health/Personal Care/Services

  • What type of healthcare and personal care services are available? Does the facility have both short and long-term services, such as routine physical and dental/vision examinations as well as skilled nursing?
  • Can the facility provide a list of available services and are residents and families involved in developing the care plan/service agreement? Who provides these services/what are their qualifications?
  • Are physical, occupational, or speech therapy services available onsite? Who coordinates these services and how are they billed to Medicare/Medicaid or other third party insurance?
  • Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? ADLs include dressing eating, mobility, hygiene, grooming (bathing, toileting, incontinence)
  • Does the residence have Alzheimer's programs, or other dementias and other specialized areas? How does staff safely manage residents who might wander?
  • Is staff available to assist residents who experience memory, orientation, of judgment losses?
  • How are medical emergencies handled? Does the residence have a clearly stated procedure for responding to medical emergencies? Is there an arrangement with a nearby hospital?
  • Are housekeeping, linen service and personal laundry included in the fees, or extra charges?
  • Does the residence provide transportation to doctors' offices, the hairdresser, shopping and other activities desired by residents and can it be arranged on short notice?
  • Are pharmacy, barber/beautician and/or physical therapy services offered on-site?
  • How does staff safely administer, monitor, and assist a resident in taking medicine?
  • Does the residence's pharmacy provide delivery, consultation and review of medicines?
  • Does a staff physician visit the resident regularly for medical checkups or can resident his/her have own personal physician?
Social and Recreational

  • What kinds of group/individual recreational activities are offered and who schedules them?
  • Is there an organized activities program with a posted daily schedule of events?
  • Do volunteers and family members come into the residence to participate/conduct programs?
  • Does the facility schedule trips or go to other events off premises?
  • Do residents participate in activities outside of the residence in the neighboring community?
  • Are the resident activity (social) areas appropriate and desirable to the prospective resident?
  • Are there supplies for social activities/hobbies (games, cards, crafts, computers, gardening)?
  • Are religious services held on the premises or arrangements made for nearby services?
  • Are there fitness facilities, as well as regularly scheduled exercise classes?
  • Does the residence create a sense of community by allowing residents to participate in certain activities or perform simple chores for the group as a whole?
  • Does facility have pets? Who is responsible for their care?

  • Are nursing staff members courteous and friendly to residents and to other staff?
  • Do nursing staff respond timely to residents requests for assistance such as help getting in and out of bed, dressing and going to the bathroom?
  • Which nursing staff members are involved in planning the resident's individual care? Are they the same ones who give the care to residents?
  • Ask questions about staff turnover. Is there frequent turnover among certified nursing assistants (CNAs)? What about turnover for nurses and supervisors, including the Director of Nursing and the Administrator?
  • What is the nursing staff to resident ratio? How many registered nurses (RNs) and Licensed Practical Nurses (LPNs) are on staff? How many per shift? What is their training/education?
  • What is the nursing assistant to resident ratio and how many are on staff? How many on each shift? What kind of training do certified nursing assistants (CNAs) receive?
  • What is history of compliance with staffing ratios? Are there incentives to help with staffing?
  • How does the nursing home ensure that all staff maintains licensure/certification, receives continuing education, and keeps their knowledge and skills up-to-date?

  • Does the residence provide three nutritionally balanced meals a day, seven days a week, and how does the menu vary from meal to meal?
  • Observe meal times. Do all residents who need assistance with eating get help? Does staff give each resident enough time to chew food thoroughly and complete the meal?
  • What about special diets; does a dietitian plan or approve menus? Are resident's weight routinely monitored?
  • Are residents involved in menu planning? Can request special foods? Are snacks available?
  • Does dining room environment encourage residents to relax, socialize, and enjoy their food
  • Are water pitchers/glasses accessible in rooms and does staff assist with drinking as needed?
  • Are common dining areas available? Is tray service available when ill and staff to assist?
  • May meals be provided at a time a resident would like or are there set times for meals?
  • May residents have guests for meals in the dining room for an additional fee? Is there a private dining room for special events and occasions?
Licensure and Certification

  • Is the facility Medicare certified and/or Medicaid certified?
  • Is this a skilled nursing facility and is a skilled bed available?
  • Is the facility accepting new patients? Is there a waiting period for admission?
  • If the facility is sponsored by a nonprofit organization and managed under contract with a commercial firm, what are the conditions of that contract?
  • Is there a resident council or organization through which resident/family have a means of voicing their views on the management of the community?
  • Each state requires the residence to be licensed and/or certified. Does the facility have a current license/certification and is it displayed?
  • Each state requires the administrator to be licensed/certified. Does she/he have current license/certification?
  • What reputation does the facility have in the community? How long has it been in business? Is it in good financial health? Does the facility follow generally accepted accounting procedures?
  • Has the facility corrected any Quality of Care deficiencies in their State inspection report?