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Back To Vidyya Searching For And Finding A Nursing Home

Check List And Additional Information

The families of your patients may find themselves faced with chosing a nursing home for a loved one. The choice is never easy and few people are equipped with the knowledge they need to make their decision wisely. The Department of Health and Human Services has developed a check list to help families make a wise and careful decision. The list includes helpful information on the Nursing Home Compare database. This database includes reports from state and federal inspections of nursing homes and is an excellent place for your patients and families to start their search. The checklist appears below. Information on Nursing Home Compare appears beneath the checklist. Vidyya hopes you find this information useful.

Nursing Home Name: _________________   Date Visited________


I. Basic Information

1. Medicare Certified:____(yes)   _____(no)

2. Medicaid Certified:____(yes)   _____(no)

3. Accepting New Patients:____(yes)    _____(no)

4. Waiting Period for Admission:____(yes)    _____(no)

5. Number of Beds in each category available to you:___________


  • Generally, skilled nursing care is available only for a short period of time after a hospitalization. Basic nursing 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.

II. Nursing Home Information:

1. The home and the current administrator are licensed____(yes)   _____(no)

2. The home conducts background checks on all staff____(yes)   _____(no)

3. The home has Special Services Units____(yes)    _____(no)

4. The home has Abuse Prevention Training____(yes)    _____(no)


  • 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: If a nursing home has special service units, learn if there are separate waiting periods or facility guidelines for when residents would be moved on or off the special unit. Some examples are: rehabilitation, Alzheimers, and hospice.
  • 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 Parts three through six, give the nursing home a grade from one to five. One is poor, five is best.

III. Quality of Life:

                                                                POOR                               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 is well-lighted.


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


(Best Possible Score:  60)

IV. Quality of Care:

                                                                POOR                               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 calls 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


(Best Possible Score:  50)


  • 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.

V. Nutrition and Hydration:

                                                                POOR                               BEST

1. The home corrected any deficiencies in these areas that were on the recent survey.


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 meal-times.


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 encourage residents to 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 dining room environment encourages residents to relax, socialize, and enjoy their food.


1             2           3           4          5


(Best Possible Score:  45)


  • Ask the professional staff how the medicine a resident takes can effect what they eat and how often they may want something to drink.
  • Visit at meal time. 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?

VI. Safety:

                                                                   POOR                               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 well-lighted.


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


(Best Possible Score:  30)


VII. Useful Tips Relating to Information in Nursing Home Compare

A national database, 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 it with 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.

Visit Nursing Home Compare to find 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 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 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 restraints.
  • When restraints are used, do the staff remove the restraints on a regular basis to help residents with moving, and with activities of daily living? 
  • Do the staff help residents with restraints to get in and out of bed and chairs when they want to get up?
  • Do staff help residents with 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 Urinary Incontinence

  • Does the nursing home smell clean?
  • Ask the staff what steps they take to prevent incontinence for residents who are at risk.

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.

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Editor: Susan K. Boyer, RN
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