Tell us how we are doing! Name:Date of Birth:Date of Stay:Food Ratings12345Please check the box that best fits your experience. 1 being the poorest quality and 5 being excellent quality.Activities Ratings123451 being the worst experience and 5 being the best experience.Staff Courtesy Ratings123451 being the worst experience and 5 being the best experience.Nursing Care RatingI did not have to wait too long for my call light to be responded to?YesNoTherapy met my expectations?YesNoCustomer Service RatingThe admission paper work was explained clearly to me and/or my family.YesNoI was included in the plan for my discharge arrangements?YesNoCleanliness RatingMy room is cleaned daily.YesNoAdditional QuestionsI would return to this facility if I required skilled nursing services again.YesNoI would recommend this facility to others.YesNoYour additional comments are appreciated.CAPTCHA