Nursing Home Checklist

This checklist will help you identify a nursing home that’s best for your relative or friend. It offers tips on what features to look for and what questions to ask when you visit prospective facilities.

Learn as much as you can about each facility that you’re considering. There are important differences among facilities you should be aware of from the range and quality of medical services available to the ease of finding a parking place when you visit. Include your relative, as much as possible, in this selection process. The facility you choose could be her home for many years.

Please print this checklist and use it when visiting nursing homes under consideration. Remember that it is unrealistic to think that every question will be answered in one visit.

• How convenient is public transportation to the home?
• Is parking available?
• What does the neighborhood look like? Will visitors feel comfortable coming here?
• Are there convenient shops and restaurants where families can take residents outside of the home?

• Is the place home-like or institutional?
• Is it well maintained, clean, well-lit, and free of unpleasant odors -- including strong disinfectant that may be masking some other smell? Are the rooms and public areas free of hazards?
• What kind of security system is in place? Is there a guard to keep uninvited people out and to keep wandering residents from the street?
• Do residents' rooms have personal belongings such as pictures, books, a plant, and a bedspread?
• How are residents' personal belongings kept safe?
• How many beds are in a room? Are single rooms available? Who gets them?
• Does the home offer private places to residents who have visitors?
• If the population is ethnically diverse, is there evidence of sensitivity to language needs -- such as signs, menus, or activities reflecting cultural and religious diversity?
• Is there a comfortable outdoor area accessible throughout the year where residents can sit, and is it being used? Do staff members escort residents to this area, or is the area in use only when visitors can escort them?
• Where do residents smoke? Are the needs of both the smokers and non-smokers being addressed?

• Are residents clean, dressed, and well?groomed? Is their hair combed? Are their nails clean and trim?
• Are most people lying in bed or moving around freely?
• Are any residents in restraints or do any appear heavily sedated?
• Are many residents engaged in interesting activities, or are most just staring at a TV set or a blank wall?
• Are they talking with each other and the staff, or do residents appear isolated from each other?

• Do you see staff members actively assisting residents?
• Is there a sufficient ratio of aides to residents on each unit, especially at night and on weekends? If they are used, will I be told when they are on duty?
• On average, how long have current workers been on staff? Are “temps” from agencies used on a typical day, particularly weekends?
• Are the nursing home workers neatly dressed and well?groomed with name badges displayed?
• Are workers abrupt or rude when asked a question?
• Do workers hand out food trays with a smile or friendly greeting?
• Are call bells and requests for assistance answered promptly?
• Do staff members, including doctors, social workers, and others, speak respectfully to the residents?
• Do staff members speak your relative's language? If not, how are language needs met for medical care, social needs, in emergencies, etc.?
• If bilingual staff is limited, what happens when they are sick, on vacation, or off-duty?

• Does the food look and taste appetizing?
• Is it served at the proper temperature?
• Do residents who need help with eating get prompt attention?
• Do most of the home's residents eat in the dining room?
• Is the menu posted and does it reflect what is actually being served?
• Are substitutes for the main dish readily available?
• Do foods served reflect the ethnic backgrounds of residents?
• Does the menu accommodate residents with specific dietary needs?
• If the home serves kosher food only, is there an area in the home where non-kosher eaters can have meals brought in from the outside, such as homemade cookies or a favorite pork dish?
• Can residents request alcoholic beverages – such as wine with dinner?

• How large is the activities room? Is it well?equipped and staffed? Are residents using it?
• If there isn’t a specific activities room, where are activities held?
• If someone is bed bound, will the home bring activities to his room? How often and what activities?
• Is a list of activities posted? Are there activities planned for the entire week, including evenings and weekends? Does the list seem varied and does it include activities your relative would enjoy?
• Are outside volunteers involved in any program at the home, for example, children from nearby schools, or entertainers, or people to help with feeding?
• Are there religious services, memorial services, recreational activities, and language or cultural clubs that meet your relative's needs?
• What holidays are celebrated and how are they celebrated?
• Are any community resources being tapped to meet the language and social needs of an underserved language group?

• If the home has an Alzheimer's unit, is it a separate area with skilled staff or is it simply a floor of the home where all the dementia patients are roomed?
• Has the staff (including custodial, CNAs and dietary) received special training to work with dementia patients?
• Will your relative be able to take advantage of the activities offered in any special unit? Is your relative's functional level higher or lower than that of most residents served in special programs that you find appealing?
• How does the staff handle disruptive behavior by residents with dementia?
• If your relative wakes often at night or wanders, how will this be addressed?
• What safety measures are in place to protect confused residents who may try to leave?

Rehab and Sub-acute Care

• Does the home offer the therapies and medical services necessary for your relative’s rehab program?
• Does the home have the proper equipment?
• Is the regular staff trained to work with rehab patients?

Admissions

• When will a bed be available for your relative?
• How long are applications kept on file? When do they need to be updated to remain active?

Medical Services

• Are there physicians on staff? How many and how often are they on the premises?
• Are specialists available (i.e. psychiatrist, optometrist, dentist, etc.)? How are specialists arranged for if needed? How long does it take for a resident to be seen?
• How can a resident get a second opinion?
• What arrangements are made for emergency treatment if the resident's physician is not available?
• What hospitals are used if the resident becomes acutely ill? How is the family notified before a resident is transferred to a hospital?
• Can you request that your relative be sent to a specific hospital other than those mentioned by the nursing home?
• How does a resident qualify for therapy?
• Does the home have a comprehensive therapy department that includes occupational, physical and speech therapy? If your relative needs extensive therapy, how often does the therapist come to the nursing home?
• Does the home offer alternative medicine and complimentary therapies?

End-of-Life Treatment

• What are the home’s policies about end-of-life treatment?
• Does the home offer a hospice program?

©2003FRIA