Resident Satisfaction Survey PLEASE RATE THE FOLLOWING: 5 = STRONGLY AGREE, 4 = AGREE, 3 = NEUTRAL, 2 = DISAGREE, 1 = STRONGLY DISAGREE EnvironmentMy room is comfortable.12345My laundry is returned promptly.12345My family is comfortable visiting me here.12345My room and the facility is clean.12345My room is treated like my home.12345I feel safe.12345The facility is free of unpleasant odors.12345Communication & RespectMy thoughts and opinions are considered in planning my schedule.12345My money in the trust fund is/was available.12345If I've voiced concerns, management has responded.12345Staff responded promptly when I asked questions.12345Staff answered questions I had.12345Staff did what they said they would.12345FoodThe quality of the food served is/was good.12345I enjoyed mealtimes.12345My special diet needs or requests are/were accommodated.12345I am/was always given a menu choice at mealtime.12345MedicalI am/was allowed to choose to receive or refuse care.12345I determined when I woke up and when I go/went to bed.12345I am/was able to see my physician when needed.12345I am/was able to see licensed nurses when needed.12345I am/was pleased with the quality of care I received.12345I felt my pain is/was managed effectively.12345Employee ContactStaff liked me.12345Staff knew me and the same staff were assigned consistently.12345Staff respected my privacy.12345Caregivers are/were respectful, concerned and caring.12345Staff pay/paid attention to me when providing care.12345OtherThe admission and/or discharge process was satisfactory.12345Staff go/went the extra mile to resolve problems.12345There are/were activities offered that are/were interesting to me.12345I am/was satisfied with religious/spiritual activities offered.12345I would recommend this facility to others who need care.12345Comments
