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Nursing Homes
Nursing Home Checklist
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Checklists can help you evaluate the nursing homes that you call or visit.
Use a new checklist for each home you call or visit. Then, compare the scores.
This will help you select a nursing home that is a good choice for you
or your relative.
Nursing Home Name: _________________________________________
Date Visited: __________________________
Address: ______________________________________________
-
Basic Information
- Is the facility Medicare certified?:____(yes) _____(no)
- Is the facility Medicaid certified?:____(yes) _____(no)
- Is this a skilled nursing facility?:____(yes) _____(no)
- Is the facility accepting new patients?:____(yes) _____(no)
- Is there a waiting period for admission?:____(yes) _____(no)
- Is a skilled bed available to you?:____(yes) _____(no)
Useful Tips
- Generally, skilled nursing care is available only for a short period
of time after a hospitalization. Custodial care is for a much
longer period of time. If a facility offers both types of care, learn
if residents may transfer between levels of care within the nursing
home without having to move from their old room or from the
nursing home.
- Nursing homes that only take Medicaid residents might offer
longer term but less intensive levels of care. Nursing Homes that
don't accept Medicaid payment may make a resident move when
Medicare or the resident’s own money runs out.
- An occupancy rate is the total number of residents currently living
in a nursing home divided by the home’s total number of beds.
Occupancy rates vary by area, depending on the overall number of
available nursing home beds.
-
Nursing Home Information:
- Is the home and the current administrator licensed?:____(yes)
_____(no)
- Does the home conduct background checks on all staff?:____(yes)
_____(no)
- Does the home have special services units?:____(yes) _____(no)
- Does the home have abuse prevention training?:____(yes) _____(no)
Useful Tips
- LICENSURE: The nursing home and its administrator should be
licensed by the State to operate.
- BACKGROUND CHECKS: Do the nursing home’s procedures to screen
potential employees for a history of abuse meet your State’s
requirements? Your State’s Ombudsman program might be able to
help you with this information.
- SPECIAL SERVICES: Some nursing homes have special service units
like rehabilitation, Alzheimer's, and hospice. Learn
if there are separate waiting periods or facility guidelines for when
residents would be moved on or off the special unit.
- STAFF TRAINING: Do the nursing home’s training programs educate
employees about how to recognize resident abuse and neglect,
how to deal with aggressive or difficult residents, and how to deal
with the stress of caring for so many needs? Are there clear
procedures to identify events or trends that might lead to abuse
and neglect, and on how to investigate, report, and resolve your
complaints?
- LOSS PREVENTION: Are there policies or procedures to safeguard
resident possessions?
For Sections III through VI, give the nursing home a grade from one to
five. One is worst, five is best.
- Quality of Life:
|
Worst |
|
|
|
Best |
1. Residents can make choices about
their daily routine. Examples are
when to go to bed or get up, when to
bathe, or when to eat.
|
1 |
2 |
3 |
4 |
5 |
2. The interaction between staff and
patient is warm and respectful.
|
1 |
2 |
3 |
4 |
5 |
3. The home is easy to visit for
friends and family.
|
1 |
2 |
3 |
4 |
5 |
4. The nursing home meets your
cultural, religious, or language
needs.
|
1 |
2 |
3 |
4 |
5 |
5. The nursing home smells and
looks clean and has good lighting.
|
1 |
2 |
3 |
4 |
5 |
6. The home maintains comfortable
temperatures.
|
1 |
2 |
3 |
4 |
5 |
7. The resident rooms have personal
articles and furniture.
|
1 |
2 |
3 |
4 |
5 |
8. The public and resident rooms
have comfortable furniture.
|
1 |
2 |
3 |
4 |
5 |
9. The nursing home and its dining
room are generally quiet.
|
1 |
2 |
3 |
4 |
5 |
10. Residents may choose from a
variety of activities that they like.
|
1 |
2 |
3 |
4 |
5 |
11. The nursing home has outside
volunteer groups.
|
1 |
2 |
3 |
4 |
5 |
12. The nursing home has outdoor
areas for resident use and helps
residents to get outside.
|
1 |
2 |
3 |
4 |
5 |
TOTAL: _____________
(Best Possible Score: 60)
- Quality of Care:
| Worst | | | | Best |
1. The facility corrected any Quality
of Care deficiencies that were in the
State inspection report. |
1 |
2 |
3 |
4 |
5 |
2. Residents may continue to see
their personal physician. |
1 |
2 |
3 |
4 |
5 |
3. Residents are clean, appropriately
dressed, and well groomed. |
1 |
2 |
3 |
4 |
5 |
4. Nursing Home staff respond
quickly to requests for help. |
1 |
2 |
3 |
4 |
5 |
5. The administrator and staff seem
comfortable with each other and with
the residents. |
1 |
2 |
3 |
4 |
5 |
6. Residents have the same care
givers on a daily basis. |
1 |
2 |
3 |
4 |
5 |
7. There are enough staff at night
and on week-ends or holidays to care
for each resident. |
1 |
2 |
3 |
4 |
5 |
8. The home has an arrangement for
emergency situations with a nearby
hospital. |
1 |
2 |
3 |
4 |
5 |
9. The family and residents councils
are independent from the nursing
home's management. |
1 |
2 |
3 |
4 |
5 |
10. Care plan meetings are held at
times that are easy for residents and
their family members to attend. |
1 |
2 |
3 |
4 |
5 |
TOTAL: _____________
(Best Possible Score: 50)
Useful Tips
- Good care plans are essential to good care. They should be put
together by a team of providers and family and updated as often
as necessary.
- Nutrition and Hydration (Diet and Fluids):
| Worst | | | | Best |
1. The home corrected any
deficiencies in these areas that were
on the recent state inspection report. |
1 |
2 |
3 |
4 |
5 |
2. There are enough staff to assist
each resident who requires help with
eating. |
1 |
2 |
3 |
4 |
5 |
3. The food smells and looks good
and is served at proper
temperatures. |
1 |
2 |
3 |
4 |
5 |
4. Residents are offered choices of
food at mealtimes. |
1 |
2 |
3 |
4 |
5 |
5. Residents’ weight is routinely
monitored. |
1 |
2 |
3 |
4 |
5 |
6. There are water pitchers and
glasses on tables in the rooms. |
1 |
2 |
3 |
4 |
5 |
7. Staff help residents drink
if they are not able to do so on their
own. |
1 |
2 |
3 |
4 |
5 |
8. Nutritious snacks are available
during the day and evening. |
1 |
2 |
3 |
4 |
5 |
9. The environment in the dining room
encourages residents to relax,
socialize, and enjoy their food. |
1 |
2 |
3 |
4 |
5 |
TOTAL: _____________
(Best Possible Score: 45)
Useful Tips
- Ask the professional staff how the medicine a resident takes can
affect what they eat and how often they may want something to
drink.
- Visit at mealtime. Are residents rushed through meals or do they
have time to finish eating and to use the meal as an opportunity
to socialize with each other?
- Sometimes the food a home serves is fine, but a resident still
won't eat. Nursing home residents may like some control over
their diet. Can they select their meals from a menu or select their
mealtime?
- If residents need help eating, do care plans specify what type of
assistance they will receive?
- Safety
| Worst | | | | Best |
1. There are handrails in the
hallways and grab bars in the
bathrooms. |
1 |
2 |
3 |
4 |
5 |
2. Exits are clearly marked. |
1 |
2 |
3 |
4 |
5 |
3. Spills and other accidents are
cleaned up quickly. |
1 |
2 |
3 |
4 |
5 |
4. Hallways are free of clutter and
have good lighting. |
1 |
2 |
3 |
4 |
5 |
5. There are enough staff to help
move residents quickly in an
emergency. |
1 |
2 |
3 |
4 |
5 |
6. The nursing home has smoke
detectors and sprinklers. |
1 |
2 |
3 |
4 |
5 |
TOTAL: _____________
(Best Possible Score: 30)
- Useful Tips Relating to Information in Nursing Home Compare
Nursing Home Compare contains summary information about nursing
homes from their last state inspection. It also contains information
that was reported by the nursing homes prior to the last State
inspection including nursing home and resident characteristics. If you
have questions or concerns about the information on a nursing home,
you should discuss them during your visit. This section contains useful
tips and questions that you may want to ask the nursing home staff,
family members and residents of the nursing home during your visit.
Nursing Home Compare Information on Results of Nursing Home
Inspections
- Bring a copy of the Nursing Home Compare inspection results for
the nursing home. Ask whether the deficiencies have been
corrected.
- Ask to see a copy of the most recent nursing home inspection
report.
Nursing Home Compare Information on Resident and Nursing
Home Characteristics
- For the Measure: Residents with Physical Restraints
- Does it appear that there is sufficient staff to assist
residents who need help in moving or getting in and out
of chairs and bed?
- Ask the Director of Nursing who is involved in the
decisions about physical restraints.
- When physical restraints are used, do the staff remove the
physical restraints on a regular basis to help residents with
moving, and with activities of daily living?
- Do the staff help residents with physical restraints to get in and
out of bed and chairs when they want to get up?
- Do staff help residents with physical restraints to move as much
as they would like to?
- For the Measure: Residents with Pressure (Bed) Sores
- Ask the staff how they identify if a resident is at risk for
skin breakdown. Ask them what they do to prevent
pressure sores for these residents.
- Ask the staff about the percentage of their residents
that have pressure sores and why.
- Do you see staff helping residents change their
positions in wheelchairs, chairs, and beds?
- For the Measure: Residents with Bowel and Baldder Incontinence
- Does the nursing home smell clean?
- Ask the staff what steps they take to prevent
bowel and bladder incontinence for residents who are at risk.
-
For the Measure: Residents Who Are Very Dependent in
Eating
- Look at your response to Question 2 in Section V above.
- Observe residents who need help in eating. Are they
able to finish their meals or is the food returned to the
kitchen uneaten?
-
For the Measure: Residents Who Are Bedfast
- Ask the Director of Nursing how staff are assigned to
care for these residents.
-
For the Measure: Residents With Restricted Joint
Motion
- Ask the Director of Nursing how the nursing home cares
for residents with restricted joint motion.
- Do the residents get help with getting out of chairs and
beds when they want to get up?
-
- For the Measure: Residents with Unplanned Weight
Gain or Loss
- Look at your responses to Questions 2, 3, 4, 5, 8, and 9
in section V above.
- For the Measure: Residents with Behavioral Symptoms
- What management and/or medical approaches for
behavioral symptoms are being used by the nursing
home?
- How does staff handle residents that have behavioral
symptoms such as calling out or yelling?
- Ask whether residents with behavioral symptoms are
checked by a doctor or behavioral specialist.
- Ask whether staff get special training to help them to
provide care to residents with behavioral symptoms.
Nursing Home Compare Information on Nursing Staff
Caring, competent nursing staff who respect each resident and family member are
very important in assuring that residents get needed care and enjoy the best
possible quality of life. Adequate nursing staff is needed to assess resident needs,
plan and give them care, and help them with eating, bathing and other activities.
Some residents (e.g., those who are more dependent in eating or who are bedfast) need
more help than other residents depending on their conditions.
The combinations of registered nurses (RNs), licensed practical and
vocational nurses (LPNs/LVNs), and certified nursing assistants (CNAs)that nursing
homes may have vary depending on the type of care that residents need and the number
of residents in the nursing home.
- Look at your responses to Questions 2 and 5 in section III above and
Questions 4, 5, and 10 in section IV above. Also look at your responses to
Questions 2 and 7 in section V above.
- Are nursing staff members courteous and friendly to residents and to other
staff?
- Do nursing staff respond timely to residents calls for assistance such as
help getting in and out of bed, dressing and going to the bathroom?
- Observe meal times. Do all residents who need assistance with eating get
help? Do staff give each resident enough time to chew food thoroughly and
complete the meal?
- Which nursing staff members are involved in planning the residents
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 nurses and supervisors,
including the Director of Nursing and the Administrator? If staff changes
frequently, ask why.
- While the number of nursing staff is important to good care, also consider
other factors, such as education and training. How many registered nurses (RNs)
are on the staff, and how many available on each shift? What kind of training
do certified nursing assistants (CNAs) receive? How does the nursing home ensure
that all staff receive continuing education and keep their knowledge and skills
up-to-date?
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