Preliminary Patient Assessment

A preliminary patient assessment is a critical first step before placing a patient in an adult family home or assisted living facility. Our registered nurses conduct comprehensive evaluations that identify care needs, medication requirements, and necessary delegation services to ensure safe, successful placements.

Why Preliminary Assessments Matter

According to the Centers for Medicare & Medicaid Services (CMS), comprehensive pre-admission assessments are essential for determining appropriate care settings and preventing placement failures. In Washington State, adult family homes must ensure they can meet patient needs before admission, as outlined in WAC 388-76.

Our preliminary patient assessments provide adult family homes and assisted living facilities with detailed, objective evaluations of patient care requirements. This information helps facilities make informed decisions about whether they can safely meet patient needs with their current staffing, training, and resources.

The assessment process follows best practices recommended by the Minimum Data Set (MDS) assessment framework, adapted for community-based care settings. The American Geriatrics Society provides guidelines for comprehensive geriatric assessment. We evaluate medical needs, functional abilities, cognitive status, behavioral considerations, and social support to create a complete picture of care requirements.

Benefits of Pre-Placement Assessment

Conducting a thorough preliminary assessment before admission provides numerous benefits for both facilities and patients:

Prevents Placement Failures: Identifies potential mismatches between patient needs and facility capabilities before admission
Ensures Patient Safety: Confirms the facility can safely meet all medical and care requirements
Identifies Delegation Needs: Determines which nursing tasks will require delegation and planning
Plans Caregiver Training: Specifies what training caregivers need before the patient arrives
Sets Realistic Expectations: Helps families understand what care the facility will provide
Supports Care Planning: Provides detailed information for developing individualized service plans

What We Assess

Our comprehensive preliminary patient assessment covers all aspects of patient care needs and requirements:

Medical History and Diagnoses

Current medical conditions and diagnoses
Recent hospitalizations or emergency department visits
Surgical history and planned procedures
Allergies and adverse medication reactions
Advance directives and code status

Medication Review

Complete list of current medications with dosages and schedules
PRN medications and parameters for administration
Recent medication changes or adjustments
Administration requirements (oral, topical, injections, etc.)
Special considerations (crushed tablets, timing with food, etc.)

Functional Assessment

Activities of daily living (bathing, dressing, toileting, eating)
Mobility and transfer requirements
Use of assistive devices (walkers, wheelchairs, etc.)
Fall risk and safety considerations
Continence status and bowel/bladder programs

Cognitive and Behavioral Status

Cognitive function and memory
Decision-making capacity
Communication abilities
Behavioral concerns or wandering risk
Depression or anxiety symptoms

Special Care Needs

Wound care or dressing changes
Diabetes management and blood glucose monitoring
Oxygen therapy or respiratory treatments
Feeding tube or special nutrition needs
Catheter or ostomy care

Our Assessment Process

We conduct thorough, systematic evaluations that provide facilities with the information needed for safe placement decisions.

1️⃣

Record Review

Before the assessment visit, we review available medical records, medication lists, hospital discharge summaries, and any prior assessments. This preparation ensures we focus assessment time efficiently on the most important areas.

2️⃣

Patient Interview and Observation

Our RN meets with the patient to assess cognitive function, communication abilities, and functional status. We observe mobility, self-care abilities, and behavioral presentation to understand real-world care needs.

3️⃣

Clinical Evaluation

We conduct focused clinical assessments including vital signs review, skin assessment for pressure injury risk, pain evaluation, and review of any specialized care needs such as wound care or tube feedings.

4️⃣

Facility Consultation

We discuss findings with facility staff, identify delegation needs, review caregiver training requirements, and provide recommendations about whether the facility can safely meet patient needs with current resources.

Assessment Report and Recommendations

Following the preliminary assessment, we provide a detailed written report within 24 to 48 hours. This comprehensive document serves as a planning tool for the facility and can be shared with the patient, family, and care team.

Report Contents

Our preliminary assessment report includes:

Executive Summary: Overview of patient care needs and appropriateness for placement
Medical Summary: Current diagnoses, recent medical events, and stability assessment
Medication Analysis: Complete medication list with delegation requirements and considerations
Functional Status: ADL needs, mobility requirements, and assistance levels
Cognitive and Behavioral Profile: Mental status, communication, and any behavioral concerns
Special Care Needs: Detailed description of any specialized nursing tasks required
Delegation Planning: Which tasks require delegation and timeline for implementation
Caregiver Training Needs: Specific training required before or shortly after admission
Recommendations: Clear guidance on placement appropriateness and preparation steps

Using the Assessment for Care Planning

The preliminary assessment provides a foundation for developing the patient individualized service plan. Facilities can use our detailed report to:

Create accurate, comprehensive initial care plans
Identify and schedule necessary delegation services
Plan caregiver orientation and training
Determine appropriate staffing patterns
Communicate clearly with families about care capabilities
Document due diligence in placement decisions

When to Request a Preliminary Assessment

We recommend scheduling a preliminary patient assessment in several scenarios:

Before Planned Admissions

Request an assessment at least one week before a planned move-in date. This timeline allows for delegation setup, caregiver training, and equipment procurement if the assessment reveals these needs.

Hospital Discharge Planning

When a potential resident is being discharged from a hospital to an adult family home, a preliminary assessment helps ensure the facility can manage post-hospital care needs, new medications, or changed functional status.

Complex Care Needs

If a patient has multiple medical conditions, takes numerous medications, requires specialized nursing tasks (insulin, tube feeding, wound care), or has cognitive or behavioral challenges, a preliminary assessment provides clarity about care requirements.

Uncertain Placement Decisions

When facility staff are unsure whether they can safely meet a patient needs, our objective professional assessment helps inform the decision. We identify what additional resources, training, or support would be needed.

Cost and Scheduling

Service Fee: 350 USD per patient

This fee includes:

Pre-visit record review
Comprehensive on-site assessment (60-90 minutes)
Detailed written report with recommendations
Facility consultation and care planning guidance
Follow-up phone consultation if needed

We typically can schedule preliminary assessments within 2 to 3 business days of your request. For urgent situations or imminent hospital discharges, we offer expedited scheduling when possible.

To schedule a preliminary patient assessment or discuss whether this service is right for your situation, call us at .

Relationship to Other Services

After the Preliminary Assessment

If the preliminary assessment confirms that placement is appropriate and identifies delegation needs, we can seamlessly transition to providing ongoing delegation services:

Initial Delegation at Move-In - Complete delegation setup when the patient arrives
New Medication Delegation - Delegation for specific medications identified in the assessment
New Caregiver Delegation - Training for caregivers who will provide the patient care

Ongoing Assessment Services

After admission, regular assessments ensure continued appropriate care:

Annual Patient Assessment - Yearly comprehensive reassessment
90-Day Supervisory Visit - Regular oversight and caregiver monitoring
Change in Condition Assessment - Evaluation when patient status changes

Frequently Asked Questions

What is included in a preliminary patient assessment?

Our preliminary patient assessment includes a comprehensive review of medical history and current diagnoses, complete medication review including dosages and administration requirements, evaluation of activities of daily living and mobility needs, assessment of cognitive function and behavioral considerations, review of special care needs such as diabetes management or wound care, analysis of necessary caregiver skills and training requirements, and determination of appropriate care setting and staffing levels.

When should a preliminary assessment be conducted?

A preliminary patient assessment should be conducted before a patient moves into an adult family home or assisted living facility. This pre-placement assessment helps ensure the facility can safely meet the patient needs, identifies necessary delegation services, determines if specialized training is required for caregivers, and prevents placement failures due to unidentified care requirements. We recommend scheduling the assessment at least one week before the planned move-in date.

How much does a preliminary patient assessment cost?

The preliminary patient assessment service is priced at 350 USD per patient. This comprehensive evaluation includes the complete assessment visit, detailed written report with care recommendations, medication review and delegation planning, caregiver training needs identification, and consultation with the facility regarding care requirements and readiness.

What happens if the assessment reveals the patient is not appropriate for the facility?

If our preliminary assessment identifies that a patient care needs exceed the facility capabilities or staffing levels, we provide detailed recommendations. This may include suggestions for alternative placement options, identification of additional services or staffing required to safely accept the patient, specific training or equipment needed before admission, or recommendations for higher-level care settings if appropriate. Our goal is to prevent placement failures and ensure patient safety.

Can the preliminary assessment be used for care planning?

Yes, the preliminary patient assessment provides valuable information for developing the initial care plan. Our detailed report includes specific care recommendations, identifies delegation needs and priorities, outlines caregiver training requirements, highlights potential challenges and solutions, and provides a baseline for ongoing care planning. Many facilities use our preliminary assessment as the foundation for creating comprehensive individualized service plans.

How long does a preliminary patient assessment take?

A thorough preliminary patient assessment typically takes 60 to 90 minutes, depending on the complexity of the patient medical history and care needs. This includes time for record review, patient interview and observation, medication review, functional assessment, and consultation with facility staff. We provide a detailed written report within 24 to 48 hours following the assessment.