Q01
メッセージ
すべてのテンプレートIndustry-Specific
Nursing Home Resident Satisfaction Survey
Captures how residents and their families experience daily care, staff responsiveness, meals, activities, and communication in a nursing home or assisted living community. An AI follow-up interview digs into the story behind the lowest-rated experience so administrators know exactly what to fix first, not just where the score dropped.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
全13問・約7分
Q02
選択式必須
Who is completing this survey?
- The resident, myself
- A family member or friend, on the resident's behalf
- A staff member assisting the resident
Q03
選択式必須
How long have you (or your loved one) lived at this community?
- Less than 3 months
- 3–12 months
- 1–3 years
- More than 3 years
Q04
オピニオンスケール必須
How likely are you to recommend this community to another family looking for care?
スケール: 0 – 10
最小:Not at all likely最大:Extremely likely
Q05
マトリクス必須
How would you rate each of the following?
6行 × 5列
- Quality of nursing and medical care
- Friendliness and respect shown by staff
- Cleanliness of rooms and common areas
- Quality and variety of meals
- Activities and social programs
- ほか1件
列: Poor · Fair · Good · Very Good · Excellent
Q06
選択式必須
In the last month, how often did staff respond to call buttons or help requests within a few minutes?
- Always
- Most of the time
- Sometimes
- Rarely
- Never
Q07
選択式
In the last month, how often did you (or your loved one) take part in group activities or social events?
- Daily
- Several times a week
- About once a week
- Rarely
- Never
Q08
ランク付け必須
If this community could improve just one area first, how would you prioritize these?
- Staff responsiveness and attentiveness
- Food and dining experience
- Activities and social engagement
- Cleanliness and upkeep
- Communication with family
- Value for the cost
ドラッグして順位を付ける
Q09
AIインタビュー
Probe the reasoning behind the respondent's recommendation score and their lowest-rated item in the ratings battery. Get a specific, recent example — a moment, incident, or interaction that shaped how they feel, not a general impression. If the resident mentioned slow response to help requests or low activity participation, ask what happened the last time this occurred and how staff or the resident reacted. If the score was high across the board, ask what one thing would make the experience even better, and probe for concreteness rather than accepting 'nothing.'
Q10
自由回答（長文）
Is there anything else you'd like management to know about the care or experience here?
Q11
プルダウン
What is the resident's age range? (Optional — for reporting purposes only)
- Under 65
- 65–74
- 75–84
- 85–94
- 95 or older
- Prefer not to say
Q12
選択式
What is the resident's gender? (Optional — for reporting purposes only)
- Male
- Female
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q13
メッセージ
Thank you for taking the time to share this feedback. Your responses will be reviewed by our care team and used to guide improvements in daily care, dining, and activities.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Includes a dedicated AI follow-up interview that probes the reasoning behind the respondent's recommendation score and their lowest-rated experience, so administrators learn the story behind the number, not just the score itself
- Combines quantitative measures (opinion scale recommendation score, matrix ratings, frequency questions on call-button response and activity participation) with a ranking question so priorities are explicit, not inferred
- Separates resident vs. family respondent identification up front and collects optional demographic context (age range, gender) for reporting without forcing disclosure
- Closes the loop with an open-ended long-text question and a thank-you message confirming responses will be reviewed, giving respondents a clear sense of follow-through
SurveySparrow
Nursing Home Resident Satisfaction Survey TemplateA ready-to-field template built specifically for nursing home resident satisfaction, covering the same general topic area as ours. It's a static question set delivered through SurveySparrow's conversational-style form UI, but the 'conversation' is templated wording rather than adaptive follow-up logic. No mention of automated scoring or AI-generated reporting on the page.
優れている点
- Purpose-built for the nursing home resident satisfaction use case
- SurveySparrow's chat-style UI can make static forms feel more personal to complete
- Likely offers easy customization within their survey builder
物足りない点
- No adaptive AI interview to dig deeper into a resident's lowest-rated experience — every respondent sees the same fixed questions
- No mention of automated per-response quality scoring or auto-generated administrator reports
- No transparent, published prompt/methodology since there's no AI-driven question logic to disclose
Jotform
Resident Satisfaction Survey Form TemplateA general resident satisfaction survey template (broader housing/community context, not nursing-home-specific by name) that can be adapted to senior care settings. It's a standard static form built on Jotform's drag-and-drop builder with typical form-logic branching, not adaptive interviewing. Good for basic data collection but not for uncovering the 'why' behind low scores.
優れている点
- Highly customizable drag-and-drop form builder
- Broad template library allows mixing in related form elements
- Simple to deploy quickly for basic feedback collection
物足りない点
- No AI-driven follow-up interview — conditional logic can branch questions but can't probe reasoning like an adaptive interview
- No automated quality scoring of open-ended responses
- No auto-generated narrative reports summarizing themes across a community
SurveyMonkey
Resident Satisfaction Survey TemplateA general-purpose resident satisfaction template (property/community oriented) that could be repurposed for a nursing home context, though it isn't framed specifically for that audience. It's a static questionnaire relying on SurveyMonkey's standard analytics dashboard rather than any adaptive interviewing capability. Useful for benchmarking scores, but not for exploring the story behind a low rating.
優れている点
- Established analytics and benchmarking tools for survey results
- Wide template library with easy sharing and distribution options
- Familiar respondent experience given SurveyMonkey's broad reach
物足りない点
- No adaptive AI follow-up interview or voice AI option to explore why a resident rated something poorly
- No automated per-response quality scoring
- No mention of transparent, published question-generation methodology
よくあるご質問
「Nursing Home Resident Satisfaction Survey」テンプレートにはどのような設問が含まれていますか？
すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Thank you for sharing your experience with us. Whether you're a resident or answering on behalf of a loved one, your hon…」・「Who is completing this survey?」・「How long have you (or your loved one) lived at this community?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか？
回答者は通常、13問を約7分で回答し終えます。
テンプレートは編集できますか？
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか？
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか？
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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