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Providing Home Care Checklist
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Nursing Homes: What to Ask

Facility Name ______________________________________________________

Address __________________________________________________________

Check: First Visit Second Visit Date(s)Visited:_____________
Circle:
Mon     Tue     Wed     Thu     Fri     Sat     Sun

You may want to attach the facility’s rate sheet for easier comparison.

The Basics: YesNo

Is the facility Medicare certified?
Is the facility Medicaid certified?
Has the license ever been revoked?
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Is the facility accepting new patients?
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Is there a waiting period for admission?
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Does the facility conduct background checks on all of the staff members?
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How many licensed nurses are on duty during each shift?
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RNs ___________ LPNs __________

What is the patient-to-staff ratio? ________________________________

Nurse-to-patient? __________ Aide-to-patient?_____________

Does the nursing home have an active family council?

What is the visiting policy? ____________________________________

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What is the facility’s discharge policy? ___________________________

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Is transportation available so the resident can visit the doctor? _________
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Does the facility hold care planning meetings at convenient times for residents and family? _______________________________________________
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Safety: YesNo

Are stairs and hallways well lit?
Are exits well marked?
Do the hallways have handrails?
Do rooms and bathrooms have grab bars and call buttons?
Are there safety locks on the doors and windows?
Are there security and fire safety systems?
Is there an emergency generator or alternate power source?
Is the floor plan logical and easy to follow?

Care Issues: YesNo

Does the facility smell fresh and clean?
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Are residents bathed and well groomed?
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Do the staff members interact well with residents?
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Do residents participate in activities and exercise?
Do residents have the same caregivers on a daily basis?
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Do the staff members respond quickly to calls for help?
Is there fresh water available in the rooms?
Does the food look and smell good?
Are the residents offered choices of food at mealtimes?
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Are the residents who need help eating or drinking receiving it?
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Are there nutritious snacks available throughout the day and evening?
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Is physical therapy available for as long as the resident needs it?
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Are the staff members well trained to deal with dementia?
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Are there units or programs for special needs such as Alzheimer’s?
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Quality of Life: YesNo

Are residents’ rights posted?
Do the staff members knock before entering a resident’s room?
Are the doors shut when the staff members dress and bathe a resident?
Is the facility an easy place for family and friends to visit?
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Does the nursing home meet cultural, religious, or language needs?
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Does the nursing home provide outdoor areas for residents and staff to get a healthy change of scenery and some fresh air together?
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Are the residents allowed to make choices about daily routines, such as when to go to bed, when to get up, when to bathe, or when to eat?
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Are the residents allowed to have personal articles and furniture in their rooms?
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Are the staff members friendly, considerate, and helpful?
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Does the facility have a warm, homey environment?
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