Please fill out our post-admission survey. Thank you for participating in the improvement of our services:
1. After you were notified that you were to receive a call from the Agency in a timely manner to set up your Initial visit?
2. Did your admitting professional give you the telephone number and contact person at the agency in case you had any questions or concerns, including after hours information?
3. Did you participate in your plan of care?
4. Did you receive information on your Bill of Rights including the State Hotline number to call if you have any complaints?
5. Did the agency admitting nurse present a professional appearance?
6. Did the nurse wear a name tag and introduce himself/herself as a representative of the agency and explain his/her role?
7. Did the nurse leave a folder with information about your care in your home?
8. Do you understand the services that your doctor ordered?
9. Did the staff tell you the date of your next visit and the frequency of visits?
10. Did the nurse take your temperature, pulse, respirations and blood pressure?
11. Did the nurse wash her hands before and after caring for you?
12. Did the nurse teach you about:
Your medications?
Signs and Symptoms to report to the doctor?
Your diet?
Wound Care (if applicable)?
Plans for discharge (if applicable)?
13. Did you feel the nurse answered your questions appropriately?
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