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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION PRINTED:12 9/2014 FORM APPROVED OMB NO. 09380391 (X3) DATE SURVEY
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How to fill out nursing home survey report

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How to fill out a nursing home survey report:

01
Start by gathering all necessary information about the nursing home, such as its name, address, and contact details. Also, make sure to have the resident's personal information, including their name, age, and medical conditions.
02
Familiarize yourself with the survey report form provided. Carefully read through the instructions and understand each section so that you can accurately provide the required information.
03
Begin the report by documenting observations of the overall facility. This includes noting the cleanliness, safety measures, and general maintenance of the nursing home.
04
Proceed to evaluate the quality of care provided to residents. Assess the staff's responsiveness, whether the residents' medical needs are being met, and the effectiveness of their treatment plans.
05
Evaluate the residents' quality of life. This involves assessing if their social, emotional, and psychological needs are being addressed, as well as their level of independence.
06
Pay attention to the nursing home's policies and procedures. Assess if they adhere to regulations and guidelines regarding resident rights, medication administration, infection control, and emergency preparedness.
07
Document any observed deficiencies or areas needing improvement. Be specific and provide detailed descriptions, as this will help guide any necessary corrective actions.

Who needs a nursing home survey report?

01
Regulatory authorities: Nursing home survey reports are typically required by regulatory authorities in order to monitor and enforce compliance with regulations and licensure requirements. These authorities use the reports to determine if the nursing home is providing adequate care and maintaining a safe environment for residents.
02
Nursing home administrators: The survey report serves as a tool for administrators to identify areas of deficiencies and implement corrective actions. It helps them improve the quality of care provided and maintain their reputation.
03
Families and residents: Nursing home survey reports are often publicly available, allowing families and potential residents to make informed decisions when choosing a nursing home. The report provides insights into the quality of care, safety measures, and overall satisfaction of residents in the facility.
04
Healthcare professionals: Survey reports can be valuable resources for healthcare professionals who work closely with nursing homes. They provide information on areas of concern that need to be addressed, allowing healthcare professionals to collaborate with the nursing home staff to improve resident care outcomes.
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Nursing home survey report is a document that provides information about the quality of care and services provided at a nursing home.
Nursing home administrators or owners are required to file the nursing home survey report.
The nursing home survey report is typically filled out online through a designated platform provided by the regulatory agency.
The purpose of the nursing home survey report is to ensure that nursing homes are providing quality care to their residents and to identify any areas that may need improvement.
The nursing home survey report must include information on staffing levels, resident care plans, medication management, and overall quality of care.
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