Nursing Home Checklist

Checklists can help you evaluate the nursing homes that you call or visit.
Use a new checklist for each home you call or visit. Then, compare the scores.
This will help you select a nursing home that is a good choice for you
or your relative.

Nursing Home Name: _________________________________________

Date Visited: __________________________

Address: ______________________________________________

    I. Basic Information

    1. Is the facility Medicare certified?:____(yes) _____(no)
    2. Is the facility Medicaid certified?:____(yes) _____(no)
    3. Is this a skilled nursing facility?:____(yes) _____(no)
    4. Is the facility accepting new patients?:____(yes) _____(no)
    5. Is there a waiting period for admission?:____(yes) _____(no)
    6. Is a skilled bed available to you?:____(yes) _____(no)

    Useful Tips

    • Generally, skilled nursing care is available only for a short period
      of time after a hospitalization. Custodial 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. Is the home and the current administrator licensed?:____(yes)
    2. Does the home conduct background checks on all staff?:____(yes)
    3. Does the home have special services units?:____(yes) _____(no)
    4. Does the home have abuse prevention training?:____(yes) _____(no)

    Useful Tips

    • 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: Some nursing homes have special service units
      like rehabilitation, Alzheimer's, and hospice. Learn
      if there are separate waiting periods or facility guidelines for when
      residents would be moved on or off the special unit.
    • 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
    • LOSS PREVENTION: Are there policies or procedures to safeguard
      resident possessions?


    For Sections III through VI, give the nursing home a grade from one to
    five. One is worst, five is best.


    III. Quality of Life

      Worst       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

    1 2 3 4 5
    5. The nursing home smells and
    looks clean and has good lighting.

    1 2 3 4 5
    6. The home maintains comfortable

    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

    TOTAL: _____________

    (Best Possible Score: 60)


    IV. Quality of Care:

      Worst       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 requests 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

    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

    TOTAL: _____________

    (Best Possible Score: 50)

    Useful Tips

    • 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 (Diet and Fluids):

      Worst       Best
    1. The home corrected any
    deficiencies in these areas that were
    on the recent state inspection report.

    1 2 3 4 5
    2. There are enough staff to assist
    each resident who requires help with

    1 2 3 4 5
    3. The food smells and looks good
    and is served at proper

    1 2 3 4 5
    4. Residents are offered choices of
    food at mealtimes.

    1 2 3 4 5
    5. Residents’ weight is routinely

    1 2 3 4 5
    6. There are water pitchers and
    glasses on tables in the rooms.

    1 2 3 4 5
    7. Staff help residents drink
    if they are not able to do so on their

    1 2 3 4 5
    8. Nutritious snacks are available
    during the day and evening.

    1 2 3 4 5
    9. The environment in the dining room
    encourages residents to relax,
    socialize, and enjoy their food.

    1 2 3 4 5

    TOTAL: _____________

    (Best Possible Score: 45)

    Useful Tips

    • Ask the professional staff how the medicine a resident takes can
      affect what they eat and how often they may want something to
    • Visit at mealtime. 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
    • If residents need help eating, do care plans specify what type of
      assistance they will receive?


    VI. Safety

      Worst       Best
    1. There are handrails in the
    hallways and grab bars in the

    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
    have good lighting.

    1 2 3 4 5
    5. There are enough staff to help
    move residents quickly in an

    1 2 3 4 5
    6. The nursing home has smoke
    detectors and sprinklers.

    1 2 3 4 5

    TOTAL: _____________

    (Best Possible Score: 30)


    Useful Tips Relating to Information in Nursing Home Compare

    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 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.

    Nursing Home Compare Information on Results of Nursing Home

    • Bring a copy of the Nursing Home Compare inspection results for
      the nursing home. Ask whether the deficiencies have been
    • Ask to see a copy of the most recent nursing home inspection


    Nursing Home Compare Information on Resident and Nursing
    Home Characteristics


      1. For the Measure: Residents with Physical 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 physical
      • When physical restraints are used, do the staff remove the physical
        restraints on a regular basis to help residents with moving, and with
        activities of daily living?
      • Do the staff help residents with physical restraints to get in and out
        of bed and chairs when they want to get up?
      • Do staff help residents with physical restraints to move as much as
        they would like to?


      2. 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?


      3. For the Measure: Residents with Bowel and Baldder Incontinence

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


      4. 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?


      5. For the Measure: Residents Who Are Bedfast

      • Ask the Director of Nursing how staff are assigned to care for these


      6. 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?


      7. 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.


      8. 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.


    VII. Nursing Home Compare Information on Nursing Staff

    Caring, competent nursing staff who respect each resident and family member are
    very important in assuring that residents get needed care and enjoy the best
    possible quality of life. Adequate nursing staff is needed to assess resident needs,
    plan and give them care, and help them with eating, bathing and other activities.
    Some residents (e.g., those who are more dependent in eating or who are bedfast) need
    more help than other residents depending on their conditions.

    The combinations of registered nurses (RNs), licensed practical and
    vocational nurses (LPNs/LVNs), and certified nursing assistants (CNAs)that nursing
    homes may have vary depending on the type of care that residents need and the number
    of residents in the nursing home.

    • Look at your responses to Questions 2 and 5 in section III above and
      Questions 4, 5, and 10 in section IV above. Also look at your responses to
      Questions 2 and 7 in section V above.
    • Are nursing staff members courteous and friendly to residents and to other
    • Do nursing staff respond timely to residents calls for assistance such as
      help getting in and out of bed, dressing and going to the bathroom?
    • Observe meal times. Do all residents who need assistance with eating get
      help? Do staff give each resident enough time to chew food thoroughly and
      complete the meal?
    • Which nursing staff members are involved in planning the residents
      individual care? (Are they the same ones who give the care to residents?)
    • Ask questions about staff turnover. Is there frequent turnover among
      certified nursing assistants (CNAs)? What about nurses and supervisors,
      including the Director of Nursing and the Administrator? If staff changes
      frequently, ask why.
    • While the number of nursing staff is important to good care, also consider
      other factors, such as education and training. How many registered nurses (RNs)
      are on the staff, and how many available on each shift? What kind of training
      do certified nursing assistants (CNAs) receive? How does the nursing home ensure
      that all staff receive continuing education and keep their knowledge and skills