Skilled Nursing Survey







Skilled Nursing Survey
We are pleased to have the opportunity to serve you and are interested in what you have to say about our services. We are committed to providing only the highest quality of care at all of our PHI communities, so your feedback and suggestions are very important to us. Thank you in advance for taking the time to share your opinion.

Stephen Proctor,
PHI President & CEO


Are you a resident?
Yes    No   

Are you a friend or family member of a resident?
Yes    No   


Please rate the questions below using a (1) one through (5) five scale
Poor - 1 or 2 | Fair - 3 | Excellent - 4 or 5 | Not Applicable - N/A
Are the staff members responsive to your questions and concerns?
1    2    3    4    5    N/A
Are you treated with dignity and respect?
1    2    3    4    5    N/A
Does the nursing staff provide high quality care?
1    2    3    4    5    N/A
Are your personal grooming needs met?
1    2    3    4    5    N/A
Is the facility free of unpleasant odor?
1    2    3    4    5    N/A
Is your room kept clean?
1    2    3    4    5    N/A
Is this a safe and secure environment?
1    2    3    4    5    N/A
Are you satisfied with the food?
1    2    3    4    5    N/A
Are you satisfied with activities?
1    2    3    4    5    N/A
Are you and your family involved in setting goals and making decisions regarding your care?
1    2    3    4    5    N/A
On a scale of 1 to 5 where 1 is "definitely would not" and 5 is "definitely would", how likely would you be to recommend this facility to a family member or friend?
1    2    3    4    5    N/A
Why do you say that?


Is there a department or staff member you care to comment about?


Additional Comments:


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