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Run: Family Satisfaction Survey – Senior Living

A family satisfaction survey for senior living communities that measures care quality, communication, dining, safety, and recommendation likelihood. Use it t...

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Overall Experience & Recommendation

How likely are you to recommend this community to a friend or family member seeking senior living? (required)

Rate on a scale of 1–5: 1 = Very unlikely, 3 = Neutral, 5 = Very likely. (Scores of 1–3 will prompt a follow-up question.)

What is the primary reason for your recommendation score?

Please share what most influenced your rating above — positive or negative.

Overall, how satisfied are you with your loved one's experience at this community? (required)

1 = Strongly dissatisfied, 2 = Dissatisfied, 3 = Neutral, 4 = Satisfied, 5 = Strongly satisfied

If your overall satisfaction score was 3 or below, what would most improve your experience?

Your candid feedback helps us prioritize improvements.

Care Quality & Clinical Responsiveness

Staff attend to my loved one's personal care needs (bathing, grooming, mobility assistance) in a timely and dignified manner. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

When my loved one has a health concern or change in condition, staff respond promptly and keep me informed. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

Medications are administered accurately and on schedule. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

My loved one's care plan reflects their individual preferences, needs, and goals. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

Please describe any care quality concern or positive experience you'd like us to know about.

Specific examples help us recognize great care and address gaps quickly.

Communication & Family Partnership

Staff proactively communicate updates about my loved one's health, activities, and well-being. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

When I raise a concern or ask a question, I receive a clear and timely response. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

I feel included as a partner in my loved one's care planning and decision-making. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

Which communication channel do you primarily use to stay connected with the community?

Select the option that best applies: Phone call / Email / In-person visits / Community app or portal / Written notices

What would improve communication between you and the care team?

Please share any suggestions — frequency, format, or content improvements are all welcome.

Dining & Nutrition

The meals served to my loved one are nutritious, appealing, and appropriate for their dietary needs. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

My loved one's food preferences, cultural considerations, and texture/consistency requirements are consistently honored. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

The dining environment is pleasant, social, and supportive of my loved one's dignity. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

Please share any specific dining concerns or compliments.

Examples: menu variety, meal timing, staff assistance during meals, hydration practices.

Environment, Safety & Activities

My loved one's living space and common areas are consistently clean, well-maintained, and free of hazards. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

I feel confident that my loved one is safe and secure within this community. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

Activities and social programs are engaging, varied, and suited to my loved one's interests and abilities. (required)

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

Please describe any environmental, safety, or activity concern you'd like leadership to address.

Specific observations (e.g., a particular area, time of day, or activity gap) are most helpful.

Open Feedback & Optional Demographics

Is there anything else you'd like to share about your loved one's experience or your own experience as a family member?

This is your space — compliments, concerns, suggestions, or anything we haven't asked about.

How long has your loved one been a resident at this community?

Optional. Helps us understand feedback in context of length of stay. Options: Less than 3 months / 3–12 months / 1–3 years / More than 3 years

How often do you typically visit or interact with your loved one and the community?

Optional. Options: Daily / Several times a week / Weekly / A few times a month / Monthly or less

What type of care does your loved one currently receive?

Optional. Options: Independent Living / Assisted Living / Memory Care / Skilled Nursing / Respite Care / Not sure

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