Nursing Home Visit Scorecard
Use it to document what you observe, what the facility says, and whether the care plan still makes sense after coverage or needs change.
Nursing home decisions are often rushed, especially after a hospitalization. This scorecard helps families compare care quality, communication, safety, and fit.
Quick answer
Use it to document what you observe, what the facility says, and whether the care plan still makes sense after coverage or needs change.
Facility Information
| Field | Notes | | --- | --- | | Facility name | | | Address | | | Contact person | | | Date visited | | | Medicare-certified? | | | Medicaid-certified? | | | Short-term rehab? | | | Long-term care? | | | Private-pay rate | | | Medicaid accepted? | |
Scorecard
Use 1-5.
| Category | Score | Notes | | --- | --- | --- | | Cleanliness | | | | Resident dignity | | | | Staff communication | | | | Staff appeared responsive | | | | Call light response observed | | | | Mealtime support | | | | Fall prevention process | | | | Pressure injury prevention | | | | Medication communication | | | | Care plan meeting process | | | | Therapy communication, if rehab | | | | Discharge planning | | | | Family involvement | | | | Dementia support | | | | Medicare/Medicaid explanation | | | | Overall trust level | | |
Observe Quietly
During the visit, notice:
- Do staff speak respectfully?
- Are residents positioned comfortably?
- Are people left unattended in distress?
- Are meals supported?
- Are hallways clear?
- Are call lights answered?
- Does the environment feel calm or chaotic?
- Are family questions welcomed?
Kefiw Tip
Ask the same question to two people:
"Who should our family call if we have a concern after admission?"
If the answers conflict, communication may be weak.
Coverage And Cost Questions
| Question | Answer | | --- | --- | | What is covered now? | | | What could change coverage? | | | What is the daily private-pay rate? | | | What happens if Medicare-covered care ends? | | | Does the facility accept Medicaid? | | | What happens if Medicaid is pending? | |
Red Flag Notes
| Red flag | Details | | --- | --- | | Poor response to residents | | | Strong odors | | | Staff seemed dismissive | | | No clear care plan process | | | Family involvement discouraged | | | Discharge plan unclear | | | Coverage explanation unclear | | | Other | |
Final Comparison Question
"Would this facility communicate clearly if something changed at 9 p.m. on a weekend?"
Reusable Product Asset Uses
This worksheet should eventually support:
- Printable PDF.
- Saveable worksheet.
- Calculator result add-on.
- Care Track step.
- Family summary export.
- Email or share version.
- Bring-this-to-a-tour version when relevant.
- Use-before-a-family-meeting version when relevant.
Professional Review
Recommended reviewer: clinician, nursing home quality expert
Sources To Verify
Last reviewed: April 29, 2026.
Kefiw Worksheet Disclaimer
Kefiw provides educational care-planning tools, worksheets, and guides. These materials are designed to help families organize information and prepare better questions. They do not replace medical, legal, financial, tax, insurance, employment, benefits, or professional care advice. Care needs, costs, coverage, provider quality, eligibility, and legal requirements vary by person, plan, provider, state, and situation. For urgent medical concerns or immediate danger, call emergency services.
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Related
Frequently asked questions
› How should families use this worksheet? How-to
Use it before a care decision, appointment, tour, provider interview, or family conversation so the discussion starts with facts instead of memory and stress.
› Is this worksheet professional advice? How-to
No. It organizes information and prepares better questions, but medical, legal, financial, tax, insurance, benefits, employment, and care decisions should be confirmed with qualified professionals.
› Should this be printed or saved? How-to
Both can help. A printed copy is useful during tours or family meetings, while a saved copy helps the family update the plan after care needs, costs, or safety risks change.
› How should I use this guide with a Kefiw tool? How-to
Use the guide as the plan and the linked Kefiw tool as the check. Read the steps first, try the move manually, then use the tool to compare outputs, catch edge cases, and decide whether the result actually fits your task.
› What mistake do tool guides help avoid? Troubleshooting
Tool guides help avoid using a utility mechanically without understanding what you are trying to accomplish. Most word, writing, and text utilities are fast, but speed can hide context mistakes. Know whether you are solving a puzzle, cleaning copy, drafting a line, or checking a rule.