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This document provides a summary of the results from a survey conducted by the Minnesota Department of Health at The Lutheran Home: Belle Plaine to assess compliance with Medicare and Medicaid participation requirements. It details findings related to patient care deficiencies, including a serious incident of elopement involving a resident. The document outlines corrective actions taken by the facility and includes information regarding future compliance expectations and enforcement remedies.
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How to fill out nursing home survey report

01
Begin by gathering all necessary information about the nursing home, including its name, address, and contact details.
02
Review the survey form and instructions carefully to understand the sections that need to be filled out.
03
Start with basic information such as the date of the survey and the name of the person completing the report.
04
Document the observations made during the survey, focusing on areas like cleanliness, staff interactions, and resident comfort.
05
Assess compliance with regulatory standards and note any deficiencies observed during the survey.
06
Include resident feedback where applicable, ensuring to capture their perspectives on care and services.
07
Fill out any required rating scales or checklists, providing detailed explanations where necessary.
08
Review the report for clarity and completeness before submitting it to the relevant authorities.

Who needs nursing home survey report?

01
Regulatory agencies that oversee nursing home operations.
02
Families and guardians of residents looking for quality assurance.
03
Healthcare professionals involved in assessing the quality of care.
04
Nursing home administrators needing to identify areas for improvement.
05
Advocacy groups concerned with the rights and well-being of residents.
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A nursing home survey report is an assessment document that evaluates the quality of care and compliance of nursing homes with federal and state regulations.
Nursing homes that receive federal funding and are certified by Medicare and Medicaid are required to file nursing home survey reports.
To fill out a nursing home survey report, facilities must gather relevant data, assess compliance with regulations, and complete all required sections accurately while providing supporting documentation.
The purpose of the nursing home survey report is to ensure the safety, health, and well-being of residents by assessing compliance with care standards and identifying areas for improvement.
The report must include information on resident care, staffing levels, safety protocols, medication management, and adherence to health regulations.
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