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PRINTED: 06/07/2022 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION

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How to fill out an onsite revisit survey

01

Start by reviewing the previous survey results to understand the areas that need to be revisited.

02

Schedule an onsite visit to the location that needs to be surveyed.

03

Use a structured approach to walk through the site and collect relevant information.

04

Record your observations and any changes or improvements that have been made since the last visit.

05

Ask for feedback from the staff or stakeholders present during the visit.

06

Summarize your findings and recommendations in the revisit survey report.

Who needs an onsite revisit survey?

01

Businesses or organizations looking to assess the effectiveness of previous recommendations and make necessary improvements.

02

Quality assurance teams interested in monitoring the progress of implementation of previous survey recommendations.

03

Consultants or auditors responsible for evaluating the compliance of a site with certain standards or regulations.

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What is an onsite revisit survey?

An onsite revisit survey is a follow-up inspection conducted at a specific location to assess any changes or improvements since the last visit.

Who is required to file an onsite revisit survey?

Business owners or managers responsible for the operation of the location are typically required to file an onsite revisit survey.

How to fill out an onsite revisit survey?

An onsite revisit survey can be filled out by providing detailed information about any updates, changes, or improvements made at the location.

What is the purpose of an onsite revisit survey?

The purpose of an onsite revisit survey is to evaluate the current status of a location and ensure compliance with regulations or standards.

What information must be reported on an onsite revisit survey?

Information such as any changes in operations, updates to safety measures, or improvements to the facility must be reported on an onsite revisit survey.

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