Free Nursing Home Handover Checklist Template
Nursing Home Handover Checklist
This checklist is designed to facilitate a thorough and smooth handover process for new residents or when transitioning care duties. Please ensure all items are completed and checked off.
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Section |
Item |
Checked |
|---|---|---|
|
Resident Information |
Full name and identification number |
|
|
Date of birth |
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Emergency contacts |
|
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Legal representative information |
|
|
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Medical Information |
Medical history summary |
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List of current medications, dosages, and schedules |
|
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Allergies and dietary restrictions |
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Recent medical assessments |
|
|
|
Physician and specialist contact information |
|
|
|
Care Plan |
Individual care plan document |
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Scheduled treatments and therapies |
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Mobility and equipment needs |
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Personal care requirements |
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Social and recreational activities plan |
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Accommodation |
Room assignment and location |
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Inventory of personal items and valuables |
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Safety and accessibility features in place |
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|
Orientation to facility layout and amenities |
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Financial and Administrative |
Review of service contract |
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Current statement of account |
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Billing and payment arrangements |
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Insurance and benefits documentation |
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Staff and Training |
Assignment of primary caregivers |
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Special training or instructions for care |
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Schedule for family meetings or updates |
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Miscellaneous |
Communication preferences |
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Personal preferences (e.g., meal times, bedtimes) |
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Any other special instructions or notes |
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Instructions for Completion:
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Ensure that all sections of the checklist are thoroughly reviewed and completed.
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For each item, place a checkmark [✓] in the "Checked" column once confirmed or completed.
Handover Completed By: [Your Name]
Date: [Month, Day, Year]
