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Facility evaluation tool

Visit every facility
with a plan.

This scorecard guides you through what to observe, what to ask, and how to compare facilities after the tour. Use it on your phone during the visit, or print it before you go.

Pro tip: Visit unannounced when possible — or at least at a time you haven't pre-announced. Arrive near a mealtime (lunch or dinner) or in the early evening. These are when staffing gaps and culture problems show up most clearly.

Facility details

Facility name

Date of visit

Time of arrival

City / State

Who visited

Care type being considered

Include memory care section

✓ Good? Unsure✗ Concern

The entrance area is clean, well-lit, and welcoming

Not clinical or institutional-feeling

There is no strong odor of urine, feces, or heavy disinfectant

Persistent odor is the single most reliable indicator of chronic understaffing

Staff you pass acknowledge you and residents warmly

Not just the admissions staff — everyone you walk by

Common areas have residents present and engaged

Residents sitting alone staring at walls is a red flag

The facility feels calm — not chaotic or understaffed

Watch for rushed staff, unanswered call lights, raised voices

You can hear activity — conversation, TV, music — not silence

Silence in a facility often means residents are isolated in rooms

The building is well-maintained — no peeling paint, broken furniture, or hazards

You are greeted promptly when you arrive

How a facility treats visitors reflects how they treat residents' families

✓ Good? Unsure✗ Concern

Staff interact with residents by name and with warmth

Generic or transactional interactions are a warning sign

Staff are moving at a purposeful but not frantic pace

Frantic pace often means short-staffing; sluggish pace means low engagement

You observe staff sitting with or spending unhurried time with residents

Even a brief moment of genuine connection matters

Staff in common areas are engaged with residents, not gathered and chatting with each other

When a resident calls out or needs help, staff respond promptly

Observe this naturally — don't just rely on what staff tell you

The admissions staff answer your questions directly, not evasively

Vague or defensive answers to basic questions should concern you

Staff speak about residents with dignity, not pity or condescension

Listen for language — it reveals culture

✓ Good? Unsure✗ Concern

Residents appear clean, groomed, and dressed in their own clothes

Residents in hospital gowns in the afternoon is a red flag

Residents in common areas appear alert and reasonably comfortable

Not necessarily happy — but not in visible distress or sedated

You observe residents being assisted in a dignified, patient manner

You do not observe residents with visible signs of neglect — soiled clothing, unkempt appearance

Residents who are able to speak respond warmly or naturally when you pass

Residents who appear fearful or withdrawn are a significant concern

Residents have personal items — photos, plants, familiar objects — in their rooms

Personalization of space reflects a culture that honors individuality

✓ Good? Unsure✗ Concern

Hallways and common areas are clean and free of clutter or hazards

Resident rooms appear clean — floors, surfaces, bathrooms

Ask to see an unoccupied room as well as a common one

Dining area is clean and set up before mealtime

A disorganized or dirty dining area before a meal is telling

There is no persistent unpleasant odor anywhere in the facility

Check hallways, resident room areas, and near the nursing station

Linens and bedding appear clean and fresh

Bathrooms and shower areas are clean and properly equipped

Check grab bars, shower chairs, non-slip surfaces

✓ Good? Unsure✗ Concern

Handrails are present and secure throughout hallways

Floors are dry, non-slip, and free of fall hazards

Wet floors, loose rugs, or clutter are fall risks

Call light cords are within reach of residents in rooms and bathrooms

Pull one gently — see how long it takes for a response

Emergency exits are clearly marked and unobstructed

The facility has visible protocols for managing wandering residents

Relevant even for non-memory care — residents with dementia may be present in any SNF

✓ Good? Unsure✗ Concern

The therapy gym or rehabilitation area is visible, active, and well-equipped

Especially important for short-term rehabilitation stays

You observe therapy being provided — not just the gym sitting empty

The nursing station is staffed and responsive

A frequently empty or chaotic nursing station is a staffing concern

Medication carts are organized and medications are being administered without rushing

The activity board or schedule shows varied, meaningful programming

Not just bingo — look for music, movement, cognitive engagement, outings

The facility has a visible care plan board or individual care documentation for residents

✓ Good? Unsure✗ Concern

Meal smells appealing and food appears well-prepared

If you visit at a mealtime, use your nose and eyes

Residents are being assisted with eating in a patient, dignified way

Rushed feeding or food being left untouched is a concern

The dining room is pleasant — tables set, social atmosphere

Not all residents eating alone in their rooms

Staff can explain dietary accommodation options clearly

Ask about special diets, allergies, personal food preferences

Ask these questions directly of the admissions coordinator or charge nurse. Write their answers — you will not remember them all. Evasive, vague, or overly polished answers deserve follow-up.

Question 1

What is your CNA (nursing aide) turnover rate in the past 12 months?

National average is ~99%/year. Below 40% is excellent. Above 60% means residents rarely see the same face twice.

Question 2

What is the nurse-to-resident ratio on the night shift and on weekends?

Evenings and weekends are when facilities are most under-resourced. A good facility answers this specifically. A vague answer is a red flag.

Question 3

Can you connect me with two or three families of current residents I could speak with independently?

A facility confident in their care will say yes. Reluctance is a signal. Any family you speak with is more candid than any staff member.

Question 4

What is your process when a family has a concern — who do we contact and what is the escalation path?

You want a clear, specific answer: charge nurse → DON → administrator → ombudsman. A vague answer means no process exists.

Question 5

Does this facility accept Medicaid, and if so, is there a separate Medicaid wing?

Many facilities have private-pay and Medicaid wings with different staffing levels. Know what your loved one will experience if they transition to Medicaid.

Question 6

What is your average response time to call lights, and how do you measure it?

Facilities that measure this are more likely to take it seriously. National guidelines suggest 5 minutes. Ask if they track it.

Question 7

What happens if my loved one's care needs exceed what this facility can provide?

You need to understand the transfer process before it becomes a crisis. A good facility has a clear, compassionate answer.

Question 8

When were you last surveyed by the state, and were any deficiencies cited?

Deficiencies are public record on Medicare's Care Compare. Asking directly — and seeing if the answer matches the record — tells you about transparency.

Overall gut feeling

After everything you've seen — how does this place feel? Trust your instincts. They matter.

Your overall impression

Notes from the visit

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Your scorecard will update as you complete each section.

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Visit every facilitywith a plan.

Overall gut feeling

Visit every facility
with a plan.