The TESS-NH is an observational instrument that gathers systematic data on the physical environment of a long-term care facility. The TESS-NH contains over 80 specific items measuring characteristics that are believed to be of importance to persons with Alzheimer’s disease and related disorders. The TESS-NH was designed primarily to survey individual environmental characteristics. It is not a scale. However, within the TESS-NH is one scale, the Special Care Unit Environmental Quality Scale (SCUEQS), which is a valid, reliable measure of overall environmental quality from the perspective of dementia care.