EVALUATING A NURSING HOME

(Nursing Homes by Forrest)

EXTERIOR

Are there wheelchair access ramps and handrails

Are the grounds and walks well maintained without clutter

If the weather and time are appropriate are residents outside

Bird feeders and seasonal plantings would be thoughtful. Are there any

HALLS AND LOBBY

Are the halls well lit

Are there handrails in the corridors

Are the halls wide enough for two wheelchairs to pass

Is the housekeeping adequate

Are the furnishings well maintained an adequate

Are the exits well market and not locked

Are safety devices such as fire extinguishes visible

Are there sufficient elevators for the number of patients

Are the laundry and food carts in the halls covered

Are residents allowed free access throughout the facility

Are state licenses on display

Is there a bulletin board indicating recent and future events

Are safety precautions taken during mopping and waxing

Are the halls cluttered

Are old cooking smells evident

Are there other stale odors

Is there a cover-up smell of disinfectant

Are residents ambulating in the halls and common areas

Is any carpeting too thick for walkers and wheelchairs

RESIDENT ROOMS

Look at more than one room and more than one unit

Do semi-private accommodations have more than the two recommended beds

Other than the hospital bed, can residents provide their own furniture

Is there privacy curtain for each bed

Is each resident area at least 80 square feet

Is each bed at least four feet from another bed

Does the room have a dresser, mirror and closet space

Are a bedside table and overhead light provided

Is there a moisture proof mattress

If the call bell becomes disconnected, does it ring the nurse

Can a private phone be installed

Can pictures be hung on the walls

Is there one comfortable chair for each resident

Is there fresh drinking water with a glass by each bed

What is the policy for room transfers

Does each resident involved have to agree on room transfers

Do the televisions have earphones

Is there room for easy wheelchair access

Does each room have a thermostat set on 72 degrees

If the room does not have air conditioners, can you install your own

May residents smoke in their rooms. If not, are there designated smoking areas

Are smoking areas well maintained and supervised

Are ashtrays plentiful, clean and well placed

RESIDENTS BATH

The bath should not be shared by more than four persons

Are there call bells near the toilet, sink and tub

Are there grab bars at the toilet and tub/shower

Does the tub/shower have a non skid bottom

Is the bath large enough for easy wheelchair access

Are raised toilets seats available

Is the bathroom clean and odor free

Are there filled soap and paper towel dispensers

DINING FACILITIES

Is the menu rotated on at least a three week cycle

Does the posted menu agree with what is actually served

Are the dishes and utensils appropriate for the patients ability

(Dishes and utensils should not be paper or plastic unless the patient is on precaution because of contagion)

Is the dining room easily accessible by wheelchair

Are aides readily available to help those who have difficulty

Are dining room personnel trained in the Heimlich maneuver

Is adequate time given to those who need time with their meals

Are meals served at rational times or for staff's convenience

There should not be more than 14 hours between meals

Is care taken with seatmate assignments

FOOD

Is the food tasty, warm and attractively prepared

Is the food warm and covered when served in the patient's rooms

Is there an alternate entree for the main meal

Are snacks and beverages served between meals

Is care taken in the preparation of special diets

Are fresh fruits and vegetables served in season

Are the servings prepackaged or cooked from scratch

RESIDENT ACTIVITIES

Does the facility have a trained recreation director

Are there recreational areas of sufficient size

Is there a recreational calendar posted that seems adequate/ Do these events actually occur

Are the activities for residents of different abilities

Are there activities for residents of divergent interests

Are special events planed for the holidays

Are wheelchair patients transported to outside activities

Are religious services available

Are hobby and game equipment available (kilns, board games, etc.)

Is there a library with current books and periodicals

Are large print material available

Is newspaper delivery available

Does the local library have bookmobile service

Will volunteers obtain books for patients

Is there transportation to events outside the facility

NURSING CARE

Are the aides certified by the state

If the are not, is there an in house training program

Is here in service training for the nursing staff

Is a nursing care plan prepared for each patient on admission

Do the staff emphasize activities for daily living

Is a licensed nurse on duty for each unit 24 hours per day

Is the facility fully staffed or does the facility use pool (outside temporary help) nurses and aides

What the average job tenure for nurses and aides

Are nurses or aides allowed to turn off call bells at the nursing stations.

What is each unit's staffing for each shift

Are bedridden patients turned and repositioned every two hours

Are physical restraints checked every two hours and the patients checked for friction marks and toileted or changed

Is the staff attitude towards patients condescending or impatient

Does the staff seem to congregate constantly at the nurses stations or the employees lounge

Does the staff interact pleasantly with the patients

Does the staff do a complete change for an incontinent patients

Does the staff attempt bladder retraining

Is the staff truly interested in rehabilitation or does their attitude seem more custodial

MEDICAL SERVICES

Does the patient present doctor have privileges

If not, who will be the patient's doctor

What hospital does the home use in an emergency

Does the patient's doctor have privileges there

What ambulance service does the home use and what is the response time

Does the ambulance service have trained Emergency Medical Technicians

Is a doctor on call 24 hours per day

Are specialists available

Will the patient have a physical at the time of admission

Can you use you own pharmacy

If not, will the pharmacy the facility uses fill prescriptions generically

Will the doctor see the patient at least every 30 days for the fist 90 days (a must)

Is a separate examination room available

Are suction machines, oxygen and other equipment available

What are the qualification of the medical director

How many other facilities does he serve

Does the medical director have a financial interest in the facility

THE RESIDENTS

Are the resident neat and are their nails trimmed

Are the men shaved

Are the women neat and the hair well kept

Are confused patients up and dressed

Do an excessive number of patients seem physically restrained

Are many patients lethargic

Are most patients dressed in clothes rather than gowns

Are the patients hesitant to speak with you

Are the patients interacting with each other

Do they seem to like the nursing home

GENERAL

Is there a patient's resident council

Is there a patient's family council

Were you given a copy of the Patients Bill of Rights

Can a spouse of a patient or lovers have privacy if they wish

Are social workers available

Are visiting hours extensive

Are children allowed to visit

Are pets allowed to be brought in

Is alcohol permitted with a doctors orders

Does the facility have a problem with theft

OTHER SERVICES

Are hairdressing and haircuts available on a regular basis

How often is persona laundry picked up and delivered

Are the appropriate therapists available

Are therapy rooms fully equipped and utilized

Are there regular visits by an optometrist

Are the regular visits by a podiatrist

Is a dentists available

Can X-rays be taken at the facility

FINANCIAL QUESTIONS

Is a contract required and can you have a copy to study

How much deposit is required

When is the balance of the deposit returned on the patients discharge

What is the basic daily rates and exactly what does it include

How much are other services

Laundry

Beautician or barber

Podiatrist

Therapists

Pharmacy

Minor medical items such s laxatives, tissues, etc.

Does the facility charge extra for special nursing such s incontinence care, feeding or other services

How are the resident's valuables such as jewelry handled

What happens if the patient's funds should be depleted and it is necessary to apply for Medicaid

WAITING LIST (where applicable)

How long is the waiting list

What is the approximate wait

What is the EXACT procedure to get placed on a list

Dose the facility give preference to hospital transfers or other medical conditions

Does the facility have any special units the potential patient might qualify for

If a bed is turned down, can the patient's name be retained high enough on the list and for what length of time