Skilled Nursing Facilities: A Visiting Checklist

Elderly man receiving care at a skilled nursing facilityNursing Homes are also known as skilled nursing facilities. In most cases, admission to a skilled nursing facility happens very quickly as a result of a hospital stay lasting three or more days.

Prior to returning home or moving into another care setting, seniors frequently require a short-term stay at a skilled nursing facility where they can receive inpatient physical, occupational and/or speech therapy. In other cases, seniors may be admitted to a skilled nursing facility to receive long-term care covered by Medicaid, particularly if finances are a concern.

Regardless of what situation precipitates the need for a skilled nursing facility, it’s important to be aware of specific indicators that can be used to measure the quality of care provided. The following checklist can be used while touring skilled nursing facilities in your area. 

Name of Skilled Nursing Facility: ___________________________________________

Date of Visit: ___________

Upon Arriving at a Skilled Nursing Facility:

  1. Is the community in good shape physically? Fresh paint, nice landscaping, clean sidewalks & patios?
  2. Do the hallways and public areas smell fresh and free of unpleasant odors? Are public restrooms kept clean for visitors?
  3. Do the residents appear well-groomed, dressed appropriately, engaged in activity?
  4. Are the staff members interactive and friendly with residents, visitors and one another?
  5. What is the ratio of staff to residents on a daily basis? Per shift? What training and qualifications are required of caregivers if they are not licensed nurses?

Questions About the Services and Service Level:

  1. How long, on average, do residents wait when they request help using a call button?
  2. Do caregivers regularly work double shifts? This should be the exception to the rule as fatigue leads to medication errors and less compassionate care.
  3. How often are care conferences scheduled among primary staff members and family to discuss, monitor and adjust the care provided to residents?
  4. Are the orders determined by care conferences and physicians followed accurately to ensure progress is made through therapies?
  5. What types of activities are available to residents and is the posted schedule of activities followed?
  6. Is transportation available for off-site medical appointments and/or can staff members coordinate transportation? This is particularly important if family members cannot provide transportation.

Understanding the Financial Component of Care:

  1. Once Medicare no longer pays 100% of care fees (after day 20), what can be expected in terms of the skilled nursing facility’s billing process? Are additional charges for supplies and medications itemized?
  2. Will long-term care insurance claims be processed by the facility or will family members be responsible for this? (If a long-term care insurance policy has been purchased by the patient.)
  3. Does the facility accept Medicaid and what assistance is provided by the staff in applying for Medicaid should it become necessary?

Find Skilled Nursing Facilities

For the results of state surveys for various skilled nursing facilities in your area, visit the Federal Medicare website, scroll down towards the bottom of the home page and click on ‘Compare Nursing Homes in Your Area.’

To view a list of local skilled nursing facilities with available beds, enter your zip code into the box below to find facilities near you.

Written by gerontologist Sara Shelton.