Nursing Home Admission Assessment Checklist
Comprehensive nursing home admission assessment covering medical, functional, psychosocial, and care planning requirements per CMS regulations.
- Industry: Healthcare
- Frequency: At admission
- Estimated Time: 60-90 minutes
- Role: Admissions Nurse/MDS Coordinator
- Total Items: 28
- Compliance: CMS LTC CoP 42 CFR 483, MDS 3.0, State Survey Requirements
Medical Assessment
Medical history and current status
- All diagnoses documented?
- Medications reconciled?
- Allergies documented?
- Advance directives obtained/documented?
- Physician admission orders received?
Functional Assessment
ADL capabilities
- Mobility status assessed?
- ADL capabilities assessed (bathing, dressing, eating)?
- Continence status assessed?
- Cognitive status screened (BIMS)?
- Communication abilities assessed?
Safety Assessment
Risk assessments
- Fall risk assessment completed?
- Comprehensive skin assessment completed?
- Pressure ulcer risk assessed?
- Nutritional risk assessment completed?
- Elopement risk assessed?
Psychosocial Assessment
Mental health and social needs
- Depression screening completed (PHQ-9)?
- Behavioral health assessment?
- Social history documented?
- Resident preferences documented?
Care Planning
Initial care plan development
- Baseline care plan initiated?
- Resident goals identified?
- Family/responsible party contacted?
- Initial care conference scheduled?
Required Documentation
Admission paperwork
- Face sheet completed?
- Admission agreement signed?
- HIPAA authorization signed?
- Resident rights provided and explained?
- Photo identification completed?
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Why Use This Nursing Home Admission Assessment Checklist?
This nursing home admission assessment checklist helps healthcare teams maintain compliance and operational excellence. Designed for admissions nurse/mds coordinator professionals, this checklist covers 28 critical inspection points across 6 sections. Recommended frequency: at admission.
Ensures compliance with CMS LTC CoP 42 CFR 483, MDS 3.0, State Survey Requirements. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Nursing Home Admission Assessment Checklist cover?
This checklist covers 28 inspection items across 6 sections: Medical Assessment, Functional Assessment, Safety Assessment, Psychosocial Assessment, Care Planning, Required Documentation. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed at admission. Each completion takes approximately 60-90 minutes.
Who should use this Nursing Home Admission Assessment Checklist?
This checklist is designed for Admissions Nurse/MDS Coordinator professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.