Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help

F-252 Environment. The facility must provide a safe, clean,
comfortable and homelike environment, allowing the
resident to use his or her personal belongings,
including some furnishings and appropriate clothing, as
space permits, unless to do so would infringe upon the
rights or health and safety of other residents.
F-253 Housekeeping and Maintenance. The facility must
provide housekeeping and maintenance services
necessary to maintain a sanitary, orderly, and
comfortable interior.
F-254 Linens Clean and in Good Condition. The facility
must provide clean bed and bath linens that are in good
condition.
F-256 Lighting Levels. The facility must provide adequate
and comfortable lighting levels in all areas.
F-257 Comfortable Temperature. The facility must provide
comfortable and safe temperature levels maintaining a
temperature range of 71-81°F.
F-258 Comfortable Sound Levels. The facility must provide
for the maintenance of comfortable sound levels.
/ /
/ /
/ /
/ /
/ /
/ /
F-271 Admission Orders. At the time each resident is
admitted, the facility must have physician orders for
the resident’s immediate care.
F-272 Comprehensive Assessments. The facility must
conduct initially and periodically a comprehensive,
accurate, standardized reproducible assessment of each
resident’s functional capacity.
F-273 Frequency of Assessments. The facility must conduct a
comprehensive assessment of a resident within 14
calendar days after admission, excluding readmissions
in which there is no significant change in the resident’s
physical or mental condition.
F-274 Significant Change. The facility should determine if
there has been a significant change (major decline or
improvement) in a resident’s status which requires
intervention, interdisciplinary review or revision of the
care plan.
RESIDENT ASSESSMENT
/ /
/ /
/ /
/ /
5.13