NURSING HOME CHECKLIST[1]

	YES	NO	COMMENTS
RESIDENTS
Dressed and well cared for	□	□
Involved in activities	□	□
Clean-shaven, hair brushed	□	□
Talking among themselves	□	□
Up and moving	□	□
Staring at walls / television	□	□
LIVING SPACES
Clean & well-kept; free from unpleasant odors	□	□
Temperature comfortable	□	□
Residents allowed to decorate own room	□	□
Private bath and toilet areas	□	□
Adequate closet space	□	□
Possessions kept secure	□	□
Furnishings attractive	□	□
STAFF
Staff relationship friendly with residents	□	□
Staff members in sight	□	□
Name tags on staff	□	□
Full time RN in nursing home at all times	□	□
Continuing education performed	□	□
Licensed doctor on staff	□	□
Administrator open to questions	□	□
SAFETY
Emergency exits, well-marked, unobstructed	□	□
Lobby and hallway clean	□	□
Non-slip surfaces / grab bars in restrooms	□	□
Call button within easy access	□	□
Number of deficiencies	□	□
Plan to correct deficiencies	□	□
Preventative care – flu shots, etc.	□	□
FOOD
Choice of food and/or special diets	□	□
Snacks available and/or can be brought into home	□	□
Staff help residents eat, if needed	□	□
ACTIVITIES / SERVICES
Pharmacy deliver medications	□	□
Continue to use my pharmacy	□	□
Physical therapy program	□	□
Active volunteer program	□	□
Outdoor areas	□	□
Organized field trips / activities	□	□
Private areas available to meet with family	□	□

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[1] Note: This document is meant for the clients of The Law Offices of Jerold E. Rothkoff. Before acting on any information presented here, you are strongly urged to consult with an attorney who is competent in this area of the law.