Medical
Nursing Home Survey Entrance Checklist
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Nursing Home Survey Entrance Checklist

1
Review state guidelines for nursing home surveys
2
Assemble survey team
3
Prepare survey materials
4
Schedule entrance conference with the nursing home
5
Conduct entrance conference
6
Tour the facility
7
Observation of daily activities and operations
8
Review facility records
9
Conduct interviews with residents
10
Approval: Resident Interviews
11
Conduct interviews with staff
12
Approval: Staff Interviews
13
Evaluate facility's compliance with regulations
14
Prepare initial survey findings
15
Present initial survey findings to facility
16
Approval: Initial Survey Findings
17
Develop plan for corrective actions
18
Present corrective action plan to facility
19
Approval: Corrective Action Plan
20
Schedule date for follow-up survey