Nursing Home Simulator · public · first seen
A meal moves through six hands: supply delivery → Cook → Steam Table → Dietary plating onto a Food Cart → CNA delivery → Resident eats. Dirty trays then travel back via the Bus Cart → Kitchen Dishwasher → clean trays restocked to the Trayline. Each meal is produced once per day; a resident who arrives after their mealtime is already "served out" won't trigger a fresh batch and instead can ask for a snack.
Kitchen — Where all kitchen equipment must be placed (Stove, Oven, Dishwasher, Sink, Steam Table, Counter, Trayline, racks, carts, Snack Fridge).
Dry Pantry — Storage for Dry Food boxes.
Fridge — Cold storage for Refrigerated Food boxes.
Freezer — Freezing storage for Frozen Food boxes.
Dining Room — Where Dining Tables must go.
Kitchen Drop-off — Delivery area for the dietary food truck.
Stove — Cooks a batch of up to 20 meals. Used by the "Dry" recipe (on its own) and the "Cold" recipe (paired with an Oven). Glows orange while cooking and holds the finished batch until a Cook unloads it.
Oven — Same as the Stove; used by the "Cold" recipe (paired with a Stove) and the "Frozen" recipe (oven only, longer cook). Holds up to 20 meals.
Steam Table — The holding counter for finished Cooked Meals (holds them until a Dietary Worker plates them). Filled meals are flagged "used this meal" so Cooks dump and clean it before the next service.
Kitchen Dishwasher — Washes dirty Serving Trays (up to 20) and Cooking Pots (up to 10) in a ~30-minute cycle. Requires Dish Detergent (one use per cycle). Auto-starts when full; a Dietary Worker unloads the clean dishes to restock.
Kitchen Sink — Used to mix Beverage Mix + water into drinks, and to dump an old Drink Cart's stale beverages.
Kitchen Counter — A single-occupancy work surface (one worker at a time). Cooks prep a batch's texture here (mincing/pureeing); Dietary Workers prep In-House Snacks here.
Trayline — Storage rack of clean Serving Trays; Dietary Workers pull trays from it while plating.
Cooking Rack — Storage rack of clean Cooking Pots (dishwasher output goes here).
Snack Fridge — Stores In-House Snacks and Pre-Packaged Snacks for residents; Dietary Workers restock it, CNAs take from it.
Food Cart — Holds up to 16 plated trays. Dietary plates onto it, pushes it out for service, and CNAs pull trays off it to deliver.
Drink Cart — Holds up to 16 beverages, up to 50 Water Mugs, and up to 50 Thickener. Pushed to the dining hall during meals; CNAs thicken resident drinks from it.
Bus Cart — Collects dirty trays/scraped dishes from the dining tables; pushed to the Dishwasher to be loaded.
Utility Cart — Used by Cooks to haul bulk ingredients (Dry/Refrigerated/Frozen Food) around the kitchen.
Dining Table — 4 seats. Residents may eat in the dining hall; a table tracks its occupants and any dirty tray left at a seat for bussing.
Dry Food — Ingredient for the "Dry" recipe. A box = 50 meal portions (stored in the Dry Pantry zone).
Refrigerated Food — Ingredient for the "Cold" recipe. Box = 50 portions (Fridge zone).
Frozen Food — Ingredient for the "Frozen" recipe. Box = 50 portions (Freezer zone).
Beverage Mix — Mixed with water at a Kitchen Sink. One box = 16 beverages.
Thickener — Thickens drinks for residents on a Nectar/Honey liquid diet. 100 uses per box.
Pre-Packaged Snacks — Store-bought snacks; taken from a Snack Fridge for snack requests.
In-House Snacks — Crafted by Dietary Workers at a Kitchen Counter from Dry/Refrigerated/Frozen Food; stored in the Snack Fridge.
Dish Detergent — Soap for the Kitchen Dishwasher (one use per wash cycle).
Water Mugs — Durable (7-day lifespan). Each holds 500cc; residents drink from them autonomously.
Serving Trays — Durable (30-day lifespan). A meal is plated onto one; they cycle through the dishwasher.
Cooking Pots — Durable (60-day lifespan). Required to load a Stove/Oven batch; washed in the dishwasher.
Cooked Meals — The produced item that sits on a Steam Table between cooking and plating (not ordered; produced by Cooks).
Meal Service & the Cook
Meal windows: Breakfast 7–9, Lunch 12–14, Dinner 17–19. Cooking windows open two hours earlier (from 5, 11, and 16) so the kitchen can cook before service.
A Cook takes the hungry residents waiting for the current meal (a batch of up to 20), picks one of three recipes (Dry → Stove; Cold → Stove + Oven; Frozen → Oven), fetches the matching food box (50 portions each) plus the needed Cooking Pots in a Utility Cart, preps the batch's texture at a Kitchen Counter, then loads and runs the machine(s). Cook time scales with the recipe (about 10 in-game minutes per machine stage).
When cooked, the Cook unloads and deposits the batch onto a Steam Table and advances each resident to the "Cooked" stage.
Cooks also dump and clean Steam Tables between meals and wash/restock trays and pots.
Meal Plating & the Dietary Worker
During mealtime, Dietary Workers check the Steam Table for Cooked residents, then plate: take a Serving Tray, take a Cooked Meal, assign it to that specific resident, and add the tray to a Food Cart until every assigned resident for that cart is plated.
They also stock and push the Drink Cart (beverages, water mugs, thickener) out before the Food Cart, then return carts to the kitchen afterward; dump old drink carts at a Kitchen Sink; make beverages from Beverage Mix + water; stock water mugs, thickener, and detergent; wash and restock trays and pots; bus dirty trays from the Bus Cart into the dishwasher; craft In-House Snacks; empty the Kitchen Trash Can; and (via the Extra Snacks trait) leave a tray of snacks at a computer station.
Delivery (CNA)
CNAs pull plated trays off the Food Cart and deliver them to each resident (in bed or to their dining seat). During a Food Rush (trays waiting on a cart), passing trays becomes their top priority — they take no breaks and answer no call lights until the cart is clear.
They refill water mugs, deliver snacks, thicken drinks for residents on a thickened-liquid diet, pickup dirty trays, and escort/assist residents to and from the dining hall.
Resident Hunger
Hunger meter: 0–100. Falls about 100 over 720 in-game minutes (~8% per hour), scaled ±25% per resident. Decay is halved while asleep or napping, and halved for 8 hours after eating a Superfood meal (see traits).
Eating refills hunger to full over the meal. A meal lasts a base 45 minutes, ±15 for that meal, ±15 for the resident — so anywhere from 15 to 75 minutes.
At hunger 0, the resident suffers a comfort penalty and gains a negative influence.
Snacks give +25 hunger and put the resident on an 8-hour (±25%) snack cooldown.
Late meals: once a mealtime is past its window and this meal is still undelivered, the resident loses comfort and calls to complain.
Resident Thirst
Thirst is a tank of 2000cc (±25% per resident), shown as a 0–100 meter. It drains over roughly 1200 waking minutes — effectively a full 24-hour day counting sleep (decay is halved while asleep/napping).
Residents autonomously sip from a Water Mug (500cc) a few times a day; once a mug is owned, it must be refilled (via a Water call) when empty or expired.
A meal with a beverage restores 200cc across the meal.
At thirst 0, the resident takes a comfort penalty, a negative influence, and can suffer faster vitals degradation from dehydration.
Snacks & Hydration requests (call lights)
Snack requests: a resident asks for a snack if hunger ≤ 50 (or they just missed a meal), or at a small spontaneous chance below hunger 90.
Water requests: raised when a resident's mug is empty/expired or their thirst hits zero.
Late-meal requests: raised when their meal is overdue.
CNAs fill water mugs at any Sink (bathroom) or Kitchen Sink.
Special Diets & Thickener
Every resident is assigned a Diet Profile at creation:
Solid texture — Regular (L7), Minced (L5), or Pureed (L4). Minced/Pureed add extra cook prep minutes at the Kitchen Counter.
Liquid consistency — Thin (L0), Nectar (L2), or Honey (L3). Thicker liquids require more Thickener and take longer to thicken.
CNAs use Thickener taken from the Drink Cart when serving a drink to a resident on a thickened-liquid diet.
Trays & Freshness
A tray is "fresh" for the first 30 minutes after plating. After that the resident loses 0.6 comfort per minute the tray sat waiting, capped at −60 comfort. Fast pass-through is rewarded.
Every employee can carry hidden Traits that quietly change how they work. You get a heads-up before hiring — each applicant's interview notes are a flavor hint at what they might be hiding.
Rolling: when an applicant is generated they roll a number of traits, weighted toward 1–2; some have none and a rare few have as many as four (range 0–4).
Hidden until they fire: on an employee's ID card a hidden trait appears only as "?????", so you can see how many they have but not what they are. A trait is revealed the first time it triggers, and a "✨ Trait Name" flashes above the worker whenever it goes off.
Opposing traits can't be held together (no "Bad Knees" + "Runner", no "Kind" + "Cold", etc.).
How often traits fire — there are two paces:
Event traits only roll at the relevant moment — clocking in, being handed a break, finishing resident care, using a computer, repairing, packing snacks, the top of the hour. 10–25% per occasion.
Minute traits roll once per in-game minute while their situation applies — walking, charting, standing near residents, gaining stress. 0.5–2% per minute, i.e. roughly once every 50–200 in-game minutes.
Each employee rolls their own fixed chance inside those ranges, so the same trait can be luckier for one worker than another.
Some effects run on their own timer: Bad Knees/Runner last 15–30 min; Focused/Easily Distracted 3–5 min; Smoker's extra break is 5 min with a ~90-min cooldown; Klepto and Hides roll about hourly; Answers Lights about every 30 min.
Role-specific traits: some are only available to certain roles — computer traits to CNA/Nurse/Maintenance, Handy/Inept to Maintenance, Lost and Found to EVS, Hides to CNA, Answers Lights to Nurse, Kind/Cold/Competent/Clumsy/Chatty/Curt to CNA/Nurse, Super Salad to Cook, Extra Snacks to Dietary.
Nearby (aura) traits are a chance-gated pulse that hits everyone within 4 tiles: Annoying/Funny nudge nearby coworkers' stress, Jokester/Grump hit them harder, Tattle-tale/Team Player affect a single nearby coworker, and Empathetic/Weird nudge nearby residents' comfort.
COMPUTERS (Nurse / CNA / Maintenance only)
Good with Computers: Using computers sometimes takes half as long.
Bad with Computers: Using computers sometimes takes twice as long.
MOVEMENT
Bad Knees: Sometimes walks at half speed for a while.
Runner: Sometimes walks at double speed for a while.
Focused: Sometimes moves with a burst of focus and speed.
Easily Distracted: Sometimes zones out and pauses what they are doing.
STRESS
Anxious: Sometimes generates twice as much stress.
Numb: Sometimes generates half as much stress.
SCHEDULE
Tardy: Sometimes arrives late for work.
Punctual: Sometimes arrives early for work.
BREAKS
All Gas: Sometimes skips their break.
Inconsiderate: Sometimes takes a longer break.
Smoker: Sometimes takes an extra 5 minute break.
AURA - STRESS (affects nearby coworkers within 4 tiles)
Annoying: Sometimes stresses out nearby coworkers.
Funny: Sometimes reduces stress of nearby coworkers.
Jokester: Sometimes tells a joke, easing nearby coworkers' stress.
Grump: Sometimes grumbles, adding to nearby coworkers' stress.
Tattle-tale: Sometimes tattles on a nearby coworker, adding to their stress.
Team Player: Sometimes covers for a nearby coworker, easing their stress.
AURA - RESIDENTS
Empathetic: Sometimes comforts nearby residents.
Weird: Sometimes unsettles nearby residents.
CARE (Nurse / CNA only)
Kind: Sometimes comforts the resident they are caring for.
Cold: Sometimes leaves the resident they are caring for uncomfortable.
Competent: Sometimes their care speeds a resident's recovery.
Clumsy: Sometimes their care slows a resident's recovery.
Chatty: Sometimes takes extra time communicating with residents.
Curt: Sometimes takes less time to communicate with residents.
MAINTENANCE ONLY
Handy: Sometimes repairs things to 150% durability.
Inept: Sometimes only repairs things to 75% durability.
EVS ONLY
Lost and Found: Sometimes finds an extra dirty linen while handling linens.
COOK ONLY
Super Salad: Sometimes cooks a superfood batch that slows hunger for 8 hours.
DIETARY ONLY
Extra Snacks: Sometimes leaves a tray of snacks at a computer for the nursing staff.
ANY ROLE
Klepto: Sometimes pockets a supply, and it vanishes.
When loading the game, the game will audit the schedule and make sure all staff members have loaded in correctly. If any staff members have glitched out and were lost to the void, a completely real and non-clone version of themselves will be dispatched back to work.
Naughty staff members have been leaving work without completing their charting. Staff Development has sent out an alert informing staff to complete ALL of their charting before clocking out. We understand that this may be stressful, however we are required by law to compensate staff with overtime should they be required to stay late.
Many, many sounds have been added. This should help add a sense of realistic overstimulation to the game, which is exactly what everyone wants to experience.
Staff will now perform a ‘reach’ in the direction of instant-actions such as handing a resident a snack or throwing away trash in a bin. This is to help make the staff feel they are actually performing an action and not simply performing a drive-by.
Increased the starting funds to $75000
New game starts with a full week of CNA + nurse coverage
First admissions batch is friendly:
forces the count to 2–3, and
clamps the insurance roll below the Private-Pay band, so no Private-Pay applicant appears — meaning any open bed works and day one can always be filled.
Staff will use clean linens if there are no wipes available.
You can now fire employees from the staffing window.
Supplies are distributed more evenly across all supply closet racks.
Building only happens when the build tab is open now. Players will no longer accidentally create or bulldoze walls or objects while the game is unpaused.
The bedside table’s tooltip will now show the resident’s “equipment”.
Redesigned the supply ui. Care-A-Zon is your one-stop shop for everything you need to run a facility.
Redesigned the staffing page.
A “suggestions” tab will now suggest what your schedule may need to make your facility run smoothly.
There are now two autofill options: “State Minimum” and “Full Roster.”
State minimum will attempt to fill the schedule to the bare minimum while also attempting to avoid any compliance issues.
Full Roster will attempt to evenly distribute the entire current roster across your entire schedule.
Redesigned the hiring screen and the hiring system. Say hello to Hire2Day!
New applicants will be posted each day.
Existing applications will expire after several days.
There is a $500 hiring fee for each new employee.
You can post an urgent job posting for a fee.
Increased resident walking speed by about 3x. Residents will still have varying speeds, as well as have reduced speeds due to lowered mobility, but it won't take the residents several hours to go to the bathroom anymore
Maintenance, EVS and other staff will experience stress as God intended.
| Depot | New manifest | Previous manifest |
|---|---|---|
| 5176651 | 6027526229835222008 | 1651452629264088657 |
| 5176652 | 5661108033869963489 | 4483790984180259917 |