Nursing Home Impact Evaluation

This evaluation aims to assess the impact of our nursing home services. Make use of the rating guide provided as your reference to realize a thorough evaluation. Include comments as necessary.

Evaluator Details

Name

Position

Evaluation Date

Rating Guide

1 - Poor: The performance is below standard, requiring immediate improvement.
2 - Fair: The performance meets minimal standards but requires significant improvement.
3 - Good: The performance meets expected standards. Continue to maintain effectiveness.
4 - Very Good: The performance exceeds standards. Keep up the good work.
5 - Excellent: The performance significantly exceeds standards. Exceptional work.

Evaluation

Criteria	Description	Rating
Patient Care	How well are the basic and medical needs of the patients met?
Facility Cleanliness	Is the facility clean, well-maintained, and suitably equipped?
Staff Professionalism	Do the staff behave professionally, demonstrating suitable skills and efficiency?
Patient Happiness	How satisfied are the patients with the services provided?
Staff-Patient Ratio	Is there an adequate number of staff for the number of patients?
Patient Safety	How safe is the environment for the patients?
Quality of Meals	Are the meals nutritious and appealing to the patients?
Family Satisfaction	How satisfied are the families of the patients with the services provided?
Staff Training	How well-trained are the staff in handling patient needs and emergencies?
Medical Equipment	Is the facility equipped with the necessary medical equipment for patient care?
Total Score

Additional Comments

No.	Comments

Thank you for taking the time to complete this evaluation. Your feedback is invaluable in helping us improve our services. If you have any questions or additional comments, please do not hesitate to contact us at [Your Company Email].