Nursing Home Information Feedback Form

Please take a few moments to answer the following questions. Your input is very important.

Responses will be used in a number of ways:
1) to enhance the web site to make it more useful.
2) to help with decisions we make regarding MDH staff training,
development of technological innovations, and
3) to inform providers as to what you, the consumer, view as important.

1) What was your primary reason for visiting our website today?

2) How did you get to our web site today?

3) What do you personally consider to be the most important consideration when selecting a nursing home for yourself, a friend, or family member? Please rank the following, using 1-6, with 1 being the most important.

1 2 3 4 5
Close to home.
Staffing levels and qualifications.
Number and types of complaints filed by residents.
State agency nursing home inspection findings.

4) Please review the following 10 items and indicate which you think are the most important for nursing home residents. You May rank all 10, or just those you believe are vital to have in place in a nursing home. Start with number 1 as the most important item.
1 2 3 4 5 6 7 8 9 10
Services must be provided by qualified staff.
Food tastes good, is fresh and properly prepared.
Care is provided so the resident maintains as much health as possible.
The nursing home is safe, clean and comfortable.
There are planned activities for residents' leisure time.
Unnecessary drugs are not given to residents.
The care plans for residents are current and easy to follow.
Services are provided that promote the dignity of residents.
Rehabilitation therapies are provided.
Residents are appropriately supervised to prevent accidents like falls.

5) How easy was it to find what you were looking for on our website?

6) How useful was the nursing home information provided?

6) What nursing home information would make this web site more useful?

7) Would you recommend this website to someone else?