Opinion Suvery

Welcome to your OPINION SURVEY

Your opinions are valuable in helping us improve the quality of our services. Kindly take a moment to fill out questions below by checking the appropriate boxes.


I and/ or my caregiver was contacted in a timely manner

My rights and responsibilities were explained.
I was informed about and given the 24 hour state hotline number in case of any problem with St. Rose of Lima Healthcare HHA services?
I was given information regarding advanced directives
I was included in the planning of my care and treatments.
Home Health Services was explained to my satisfaction.
Home health services staff washed their hands or used hand sanitizer upon arrival and before and after treatments.
My medications were reviewed and explanation was provided.
Please rate Care Provider (s) according to the following Safety instruction provided.

5=Excellent 4= Very Good 3=satisfactory 2=Fair 1=Unsatisfactory Please leave blank if the statement does not apply in your case.

Nurse = your RN or LVN     Aide = the person who helps you with your activities of daily living.    PT = your Physical Therapist  SC= Chaplain OT = your Occupational Therapist     ST = your Speech Therapist     MSW = your Social Worker

Effective instruction provided regarding management of my pain.

Courtesy and respectfulness
Efficiency and competence
Clear Emergency Management Instructions
Discussing your visit schedule
Planning and carrying out your care
Discussing your discharge plan
Was the instruction of safety adequate
Was pain management instruction effective
Overall abilities in meeting needs and expectation
Would you use St Rose of Lima Healthcare HHA again or recommend the Agency to others

Still Have Questions?