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Name: Fillable Online Nursing Home Survey Report Details for BETTENDORF HEALTH CARE CENTER on 06/11/2020. Survery Reports Fax Email Print - pdfFiller
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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONPRINTED:7/8/2020 FORM APPROVED OMB NO. 09380391 (X3) DATE SURVEY COMPLETED(X1)

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How to fill out nursing home survey report

01

Step 1: Gather all necessary information and documents related to the nursing home and its operations.

02

Step 2: Review the survey report form provided by the regulatory authority or agency.

03

Step 3: Begin filling out the report by entering the required general information, such as the name and address of the nursing home.

04

Step 4: Proceed to answer each question or section in the report accurately and thoroughly.

05

Step 5: Provide any additional requested documentation or evidence to support your answers, if required.

06

Step 6: Ensure all necessary signatures and certifications are included at the appropriate sections of the report.

07

Step 7: Review the completed report for any errors or missing information.

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Step 8: Submit the filled-out nursing home survey report to the relevant regulatory authority or agency by the specified deadline.

09

Step 9: Keep a copy of the report and any supporting documents for your records.

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Step 10: Cooperate with any follow-up actions or investigations that may result from the survey report.

Who needs nursing home survey report?

01

Nursing home administrators and staff

02

Government regulatory authorities or agencies

03

Healthcare professionals involved in the supervision or oversight of nursing homes

04

Policy makers and researchers in the field of elder care

05

Insurance companies or agencies

06

Legal entities handling cases related to nursing home care

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What is nursing home survey report?

A nursing home survey report is a formal evaluation document that assesses the quality of care, safety standards, and compliance with regulations in a nursing home facility.

Who is required to file nursing home survey report?

Nursing homes that receive federal or state funding, as well as those that are licensed to operate, are required to file nursing home survey reports.

How to fill out nursing home survey report?

To fill out a nursing home survey report, you need to gather relevant information about the facility, including staffing, resident care, compliance with regulations, and financial data, and then complete the provided forms accurately.

What is the purpose of nursing home survey report?

The purpose of a nursing home survey report is to ensure that facilities meet health and safety standards, provide quality care to residents, and comply with applicable laws and regulations.

What information must be reported on nursing home survey report?

The report must include information on the facility’s staff qualifications, resident care practices, safety measures, financial performance, and compliance with federal and state health regulations.

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