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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION PRINTED:8 18/2015 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 relevant information about the nursing home, including its name, address, and contact information.
02
Begin the report by providing background information about the survey, such as the date it was conducted and the purpose of the survey.
03
Follow a structured format while filling out the report, ensuring that all required sections are completed accurately and thoroughly.
04
Include detailed observations about the nursing home's facilities, cleanliness, and overall environment.
05
Document any potential health and safety concerns, such as equipment malfunctions or unsanitary conditions.
06
Take note of the residents' well-being and satisfaction by assessing their comfort, engagement in activities, and interactions with staff members.
07
Include relevant information about the nursing home's staffing levels, qualifications of the staff, and any training programs in place.
08
Offer objective assessments about the nursing home's compliance with regulations and licensing standards.
09
If applicable, document any incidents or complaints received during the survey and provide recommendations for improvement.
10
Conclude the report with a summary of the overall findings and recommendations for the nursing home to enhance its quality of care.

Who needs a nursing home survey report?

01
Regulatory bodies: Government agencies responsible for overseeing nursing home facilities require survey reports to ensure compliance with regulations and licensing standards.
02
Nursing home administrators: In order to assess the performance and quality of care provided by their facility, administrators rely on survey reports to identify areas of improvement and track progress.
03
Current and potential residents: The survey report serves as a transparency tool for those considering a nursing home, helping them make informed decisions about the quality of care provided.
04
Families and loved ones: Survey reports provide valuable insights into the quality of care and living conditions within a nursing home, helping families make decisions regarding their loved ones' long-term care options.
05
Healthcare professionals: Physicians, nurses, and social workers also benefit from survey reports when coordinating care for residents or referring patients to nursing home facilities.
Remember, it is crucial to approach the survey report's completion methodically and accurately to ensure the gathered information reflects the reality of the nursing home and assists in improving its overall quality of care.
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Nursing home survey report is a report that provides information about the conditions and quality of care in a nursing home facility.
Nursing home administrators or authorized representatives are required to file the nursing home survey report.
Nursing home survey report can be filled out by documenting observations and findings during an inspection of the facility.
The purpose of nursing home survey report is to ensure that nursing homes are providing quality care and meeting regulatory requirements.
Information such as facility cleanliness, staff qualifications, resident safety, and quality of care must be reported on the nursing home survey report.
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