Office of Disability Concerns - Housing

Nursing Home Checklist

Name of Nursing Home__________________________Date of Visit_________________

Person Talked to________________________________

Basic Information

YES

COMMENTS

The nursing home is Medicare-certified.

The nursing home is Medicaid-certified.

The nursing home has the level of care you need (e.g. skilled, custodial), and a bed is available.

The nursing home has special services if needed in a separate unit (e.g. dementia, ventilator, or rehabilitation), and a bed is available.

The nursing home is located close enough for friends and family to visit.

Resident Appearance

YES

COMMENTS

Residents are clean, appropriately dressed for the season or time of day, and well groomed.

Nursing Home Living Spaces

YES

COMMENTS

The nursing home is free from overwhelming unpleasant odors.

The nursing home appears clean and well kept.

The temperature in the nursing home is comfortable for residents.

The nursing home has good lighting.

Smoking is not allowed or may be restricted to certain areas of the nursing home.

Furnishings are sturdy, yet comfortable and attractive.

Noise levels in the dining room and other common area are comfortable.

Staff

YES

COMMENTS

The relationship between the staff and the residents appears to be warm, polite, and respectful.

All staff wear name tags.

Staff will knock on the door before entering a resident’s room and refer to residents by name.

The nursing home offers a training and continuing education program for all staff.

The nursing home does background checks on all staff.

The guide on your tour knows the residents by name and is recognized by them.

There is a full-time Registered Nurse (RN) in the nursing home at all times, other than the Administrator or Director of Nursing.

The same team of nurses and Certified Nursing

Assistants (CAN’s) work with the same resident four to five days per week.

CAN’s work with a reasonable number of residents.

CAN’s are involved in care planning meetings.

There is a full-time social worker on staff.

There is a licensed doctor on staff. Is he or she there

daily? Can he or she be reached at all times?

The nursing home’s management team has worked

together for at least one year.

Yes

Comments

Resident’s Rooms

Residents may have personal belongings and/or

furniture in their rooms.

Each resident has storage space (closet and drawers) in

his or her room.

Each resident has a window in his or her bedroom.

Residents have access to a personal telephone and

television.

Residents have a choice of roommates.

Water pitchers can be reached by resident.

There are policies and procedures to protect residents’

possessions.

Hallways, Stairs, Lounges, And Bathrooms

Exits are clearly marked.

There are quiet areas where residents can visit with

friends and family.

The nursing home has smoke detectors and sprinklers.

All common areas, resident rooms, bathrooms and doorways are designed for wheelchair use.

There are handrails in the hallways and grab bars in the bathrooms.

Menus and Food

Residents have a choice of food items at each meal.

(Ask if your favorite foods are served.)

Nutritious snacks are available upon request.

Yes

Comments

Activities

Residents, including those who are unable to leave their rooms, may choose to take part in a variety of activities.

The nursing home has an active volunteer program.

Safety and Care

The nursing home has an emergency evacuation plan

and holds regular fire drills.

Residents get preventive care, like a yearly flu shot,

to help keep them healthy.

Residents may still see their personal doctors.

The nursing home has an arrangement with a nearby

hospital for emergencies.

Care plan meetings are held at times that are convenient for residents and family members to attend whenever possible.

The nursing home has corrected all deficiencies (failure to meet one or more Federal or State requirements) on its last state inspection report.

Use [Nursing Home Compare] http://www.medicare.gov/ to help compare nursing homes.

Call the Statewide Senior Information Line at 1-800-211-2116 or the Office of Disability Concerns (ODC) at 1-800-522-8224 or (405) 521-3756 for your nearest AoA.

This article was adapted by the Office of Disability Concerns from the Guide to Choosing a Nursing Home, prepared by Centers for Medicaid Services. The Guide to Choosing a Nursing Home is not a legal document. The official Medicare Program provisions are contained in the relevant laws, regulations and rulings.

Important Information if you have Medicare:

Medicare Benefits: Although Medicare does not pay for most nursing home care, you will still be able to get Medicare-covered benefits when you live in a nursing home. For example, if you have Medicare Part B, you will still be covered for your yearly flu shot and all other Medicare-covered preventive services.

Hospital Discharge: Many people enter a nursing home after a hospital stay. If you have Medicare and think you are being asked to leave the hospital too soon, you can ask for a review from the Quality Improvement Organization (QIO). Their telephone number is on the copy of An Important Message about Medicare Rights:

Admission, Discharge, and Appeals that you got when you were admitted to the hospital. You must ask for the review by noon of the first working day after the hospital gives you a written “Notice of Non-Coverage.” You don't have to pay for your hospital stay while the QIO reviews your request. It can take up to three working days.

Skilled Nursing Care: If you need Medicare-covered skilled nursing care after a Medicare-covered hospital stay of three days or more, ask the nursing home staff if they provide the skilled care you need, and if the nursing home is Medicare-certified.

If you need more information on Medicare coverage of skilled nursing facility care, look at http://www.medicare.gov/ on the web. Select “Publications” to look at or print a copy of the booklet Medicare Coverage of Skilled Nursing Facility Care (CMS Pub. No. 10153). You may also order a free copy by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.