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Facility Atmosphere: |
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| 1. This facility has a
friendly atmosphere |
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| 2. The staff are courteous |
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| 3. Family, friends or
visitors are treated well |
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| 4. Managers respond to
concerns |
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| Quality of Life: |
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| 5. Staff treat me with
respect |
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| 6. Staff respect my choices
and preferences |
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| 7. I enjoy enough privacy |
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| 8. I feel safe |
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| 9. My belongings are secure |
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| 10. I don't usually feel
lonely here |
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| 11. I like the way my room
is set up |
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| Quality of Care: |
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| 12. I receive good care
from nurses |
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| 13. I receive good care
from nurse-aides |
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| 14. I receive good care
from doctors |
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| 15. Therapy services are
good |
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| 16. The activity programs
are good |
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| 17. The facility keeps my
family informed |
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| |
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| Quality of
Service: |
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| 18. Meals served are good |
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| 19. Dining experience is
enjoyable |
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| 20. Laundry service is good |
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| 21. The premises are clean |
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| |
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| Quality of Staff: |
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| 22. Staff are competent |
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| 23. Staff are caring |
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| 24. Staff respond to my
needs |
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| Overall
Satisfaction: |
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| 25. All things considered,
I am satisfied with this facility |
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| 26. I would recommend this
facility to others |
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| |
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