Sunday, December 4, 2011

Skilled Nursing Facility Comparison Checklist

Back to my blog home page: http://travelingotr.blogspot.com

Three weeks ago, I wrote a blog on what to look for if you are interviewing and comparing skilled nursing facilities for a loved one who needs care.

Feel free to use and reproduce this basic checklist; however, please credit the source if you share it.


Skilled Nursing Facility Comparison Checklist
Copyright © 2011. Thresa M. Kussman, MOT, OTR
http://travelingotr.blogspot.com




Criteria
Name of Facility
Name of Facility
Name of Facility
Five Star Rating
1 (poor) –
5 (excellent)

1 (poor) –
5 (excellent)
1 (poor) –
5 (excellent)
Deficiencies
Staffing
Hydration
Weight Loss
Skin Integrity
Range of Motion
Privacy
Infection Control
Dietary
Falls with Injury
Other
Staffing
Hydration
Weight Loss
Skin Integrity
Range of Motion
Privacy
Infection Control
Dietary
Falls with Injury
Other
Staffing
Hydration
Weight Loss
Skin Integrity
Range of Motion
Privacy
Infection Control
Dietary
Falls with Injury
Other

First Impressions
Initial call
Professional
Friendly
Rude
Other
Professional
Friendly
Rude
Other
Professional
Friendly
Rude
Other

Was I put on hold?
Yes
No
Yes
No
Yes
No

How long?
Under 1 min
2-4 minutes
5 minutes+

Under 1 min
2-4 minutes
5 minutes+
Under 1 min
2-4 minutes
5 minutes+
Outside of building
Clean
Welcoming
Contemporary
Aged
Dirty
Unkempt
Clean
Welcoming
Contemporary
Aged
Dirty
Unkempt
Clean
Welcoming
Contemporary
Aged
Dirty
Unkempt

Inside of building

Calm
Friendly
Chaotic
Stressful
Odor
Other

Calm
Friendly
Chaotic
Stressful
Odor
Other

Calm
Friendly
Chaotic
Stressful
Odor
Other

Lobby
Clean
Welcoming
Contemporary
Aged
Dirty
Unkempt

Clean
Welcoming
Contemporary
Aged
Dirty
Unkempt

Clean
Welcoming
Contemporary
Aged
Dirty
Unkempt

What did I hear?

Music
Laughter
Silence
Buzzers
Alarms
Residents
Overhead pages
Other

Music
Laughter
Silence
Buzzers
Alarms
Residents
Overhead pages
Other

Music
Laughter
Silence
Buzzers
Alarms
Residents
Overhead pages
Other

Nurses’ Station
Buzzers going off?

Yes
No
Yes
No
Yes
No
Do staff acknowledge me?

Yes
No
Yes
No
Yes
No
Are charts protected from view?

Yes
No
Yes
No
Yes
No
Is it a quiet environment for my loved one?
Yes
No
Yes
No
Yes
No
Residents
Hair combed?
Yes
No
Yes
No
Yes
No
Faces clean?
Teeth brushed?

Yes
No
Yes
No
Yes
No
Fingernails trimmed & clean?

Yes
No
Yes
No
Yes
No
Clothing free of food stains?

Yes
No
Yes
No
Yes
No
Wheelchairs clean?

Yes
No
Yes
No
Yes
No
Rooms
Bedroom




Private
One roommate
Two roommates

Private
One roommate
Two roommates
Private
One roommate
Two roommates
Dining Room
Attentive nurse aides?
Yes
No
Yes
No
Yes
No
Age appropriate music?

Yes
No
Yes
No
Yes
No
Showers / Bathrooms
Showers clean?

Yes
No
Yes
No
Yes
No
Bathrooms clean?

Yes
No
Yes
No
Yes
No
Enough turning radius for a wheelchair in bathroom?

Yes
No
Yes
No
Yes
No
Visitor bathroom clean?
Yes
No
Yes
No
Yes
No
Therapy
Rehab
Physical
Occupational
Speech
Restorative Nursing Exercise
Physical
Occupational
Speech
Restorative Nursing Exercise
Physical
Occupational
Speech
Restorative Nursing Exercise
If my loved one is on Medicaid, does facility offer therapy?

Yes
No
Yes
No
Yes
No

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