Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help

change of condition reassessment:
Care Plan
HCP
goal measurable:
date:
Review
accurate:
date interdisciplinary:
resident participates:
Lab / X-Ray
drawn timely:
evaluated:
follow-up:
Dr. notified:
Miscellaneous
treatment sheet:
MAR:
flow sheet:
weight sheet:
follow-up intervention:
timely assessments:
Social Services
room moves:
behavior problems:
follow-up intervention:
timely assessments:
Activities
patient possessions list:
timely assessments:
unusual needs:
Dietary
complete diet assessment:
adequate documentation:
recommendations follow-up:
Restorative
assessment timely:
complete:
accurate:
weekly progress notes:
monthly summary:
care planned:
Rehabilitation
timely screens:
assessment timely:
complete:
accurate:
weekly progress notes:
physician orders clarified / accurate:
care planned:
Completed By:
Comments:
5.76