For many Washington families, the RN pre-placement assessment is the first time a nurse is evaluating their parent specifically to determine whether and how a care home can support them. It's a required step before any AFH move-in — and it's less intimidating than it sounds.
Here's exactly what happens, step by step.
Before the visit
The assessment starts before the nurse arrives:
- The family or facility schedules the visit for a time the resident is at their best
- You gather the key records: current medication list, physician's report, diagnoses, and any recent discharge paperwork
- The RN may ask for a brief phone call to confirm the resident's baseline
The on-site visit (about 60–90 minutes)
The nurse meets the resident — usually at the adult family home — and works through the evaluation systematically:
1. Health history review. The RN goes through diagnoses, hospitalizations, falls, and changes since the last medical visit.
2. Medication reconciliation. Every medication — name, dose, frequency, route — is verified against the physician's orders and the facility's list. This is where the RN identifies which medications will need delegation and whether any conflict exists.
3. Functional assessment. The nurse evaluates:
- Mobility and transfers (can the resident get to the bathroom? stand from a chair?)
- Balance and fall risk
- Hearing, vision, and communication
- Continence needs
4. Cognitive evaluation. Memory, orientation, judgment, and safety awareness — all of which determine how much supervision is needed.
5. Daily-living needs. Bathing, dressing, grooming, eating, and meal/nutrition requirements.
6. Behavioral and social review. Mood, routines, and any behaviors the care team should anticipate.
7. Environmental check. The RN verifies the home can support the resident safely — equipment, layout, and caregiver capacity.
After the visit
Within 48 hours, the RN delivers the written assessment report. It includes:
- The full clinical summary
- Care needs and recommended level of support
- A determination of whether the home can safely meet the resident's needs
- Which tasks are delegated and to whom
- The foundation for the facility's care plan
Who is present
Usually the resident, the RN, and a family member or facility representative. The family is encouraged to attend — it's your chance to hear the clinical picture and ask questions.
What it is not
It is not a medical exam or a diagnostic workup. The RN is not treating anything — they're evaluating the match between your parent's needs and the home's ability to provide safe care. That's the distinction that makes the assessment the right-sized, mandatory step it is.
How long and how much
Plan for 60–90 minutes on site and a report within 48 hours. At Seattle Nurse Delegation the flat rate is $450 — see the cost breakdown for why. When you're ready, book your assessment or learn how to schedule it around your move-in date.