Nursing Home Checklist

Nursing Home Checklist (1)

Cleanliness:

· Is the facility clean and free of unpleasant odors? [] yes [] no

Patient Rights/Autonomy:

· Does the facility have a written description of resident's rights and responsibilities? [] yes [] no

· Is the staff trained to protect the resident's dignity and privacy? [] yes [] no

· Is use of restraining devices minimal? If so, has every effort been made to alternatives? [] yes [] no

seek

Care Planning:

· Are patients and families involved in developing their own care plan? [] yes [] no

· Does the facility provide services for terminally ill patients/families? [] yes [] no

· Does the facility have a sub-acute care program? [] yes [] no

Staff:

Does the staff show interest, affection, courtesy and respect for individual patients? [] yes [] no

Does the staff respond quickly to patients' calls for assistance? [] yes [] no

Is the administrator available to answer your questions? [] yes [] no

Licensure and Certification'

Is the facility/administrator licensed? [] yes [] no

Is the facility Medicare-and/or Medicaid-approved? [] yes [] no

Does the facility have a formal quality assurance program? [] yes [] no

Location'

· Is the facility located close to you? [] yes [] no

· The patient's doctor? [] yes [] no

Costs:
The hospital? [] yes [] no

Are all the services the resident requires covered in the basic daily charge? [] yes [] no

· If not, is a list of non-covered services available? [] yes [] no

Nursing Home Checklist (2)

Medical:
    ·    Are personal physicians allowed and will they be notified in the case of an emergency?
        [] yes [] no

· Are residents and family members involved in the treatment plans? [] yes [] no

· Are other medical services available (dentists, podiatrists, etc.)? [] yes [] no

Hospitalization:
· Is emergency transportation available? [] yes [] no

· Does the facility hold the resident's bed when he/she is being hospitalized?

[] yes [] no

Pharmacy:
· Are routine and emergency drugs available? [] yes [] no

· Does a pharmacist review patient drug regimens? [] yes [] no

· Is a pharmacist available for staff and patients? [] yes [] no

Therapy Program:

· Is there a physical therapy program available under the direction of a qualified physical therapist? [] yes [] no

· Are services of an occupational and speech therapist available? [] yes [] no

Activities Program: ram:
· Are group and individual activities available? [] yes [] no

· Do volunteers work with the residents? [] yes [] no

· Are outside trips planned? [] yes [] no

Social Services:
· Is a social worker available to assist residents and families? [] yes [] no

Accident Prevention:
· Is the facility well lighted inside and outside? [] yes [] no

· Are chairs sturdy and not easily tipped? [] yes [] no

· Are handrails in hallways and grab bars in bathrooms? [] yes [] no

Nursing Home Checklist (3)

Fire Safety:

Does the facility meet federal and/or state codes? [] yes [] no

· Are the exits clearly marked and unobstructed? [] yes [] no

· Are fire drills conducted? [] yes [] no

· Are doors to the stairways kept closed? [] yes [] no

Bedrooms:
· Does each patient's room have a window? [] yes [] no

· Is there a privacy curtain and a nurse call bell available for each bed? [] yes [] no

· Is fresh drinking water beside each bed? [] yes [] no

· Is there at least one comfortable chair per patient? [] yes [] no

    ·    Is there enough room for a wheelchair to maneuver & is there easy access to each bed?
        [] yes [] no

Hallways:
    · Are halls large enough for two wheelchairs to pass easily? [] yes [] no

· Do halls have hand railings? [] yes [] no

Dining Room:
· Is the dining area attractive and inviting? [] yes [] no

· Are tables convenient for those in wheelchairs? [] yes [] no

· Is there adequate time to eat meals? [] yes [] no

Kitchen:
·Is the food preparation area separate from the dishwashing and garbage area?
[] yes [] no

· Does the kitchen help observe sanitation rules? [] yes [] no

Activities:
· Is there equipment for patient activities (such as games, easels, etc.)? [] yes [] no

· Are the residents using the equipment? [] yes [] no

Nursing Home Checklist (4)

Toilet Facilities:

· Are the toilets wheelchair-accessible and do they have nurse call bells close by? [] yes [] no

· Do the bathtubs and showers have non-slip surfaces and hand grips? [] yes [] no

Grounds:

· Is there easy access for the handicapped? [] yes [] no

· Are walkways free of hazardous objects? [] yes [] no

Religious Observances:

· Are arrangements made for the residents to worship as they please? [] yes [] no

Food:

· Does a dietitian plan menus for patients on special diets? [] yes [] no

· Is food delivered to patients unable or unwilling to eat in the dining room? [] yes [] no

Does staff assist patients who need help with eating? [] yes []

no

Grooming:

· Is assistance in bathing and

grooming available? [] yes []

· Are barbers and beauticians available? [] yes [] no

· Are basic personal laundry services available? [] yes [] no

YOUR PART:
If you are selecting a nursing
facility for a loved one, are you:

Involving this person in the choice? [] yes [] no

Ready to visit the patient frequently and encourage friends to make similar visits? [] no
[] yes

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