QA Privilege Evaluation
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1
. What is your occupation?
What is your occupation?
CMS Representative
Director of Nursing
Nursing Home Administrator
Nursing Home Consultant
Nursing Home Provider Organization Representative
OQA Surveyor - NERO
OQA Surveyor - NRO
OQA Surveyor - SERO
OQA Surveyor - SRO
OQA Surveyor - WRO
PRQI Consultant / Staff
RCRS Staff
Other (please specify)
2
. What is your overall evaluation of this presentation?
What is your overall evaluation of this presentation?
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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3
. How did you participate in this presentation?
How did you participate in this presentation?
In-person
Live webcast
On-demand webcast (recorded)
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4
. Please enter the date you viewed this presentation.
Please enter the date you viewed this presentation.
5
. Please rate the usefulness of the information provided.
Please rate the usefulness of the information provided.
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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6
. Please rate the quality of the handouts / visuals used.
Please rate the quality of the handouts / visuals used.
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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7
. Please rate the pace of the presentation.
Please rate the pace of the presentation.
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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8
. Please rate the presenters:
Agree
Disagree
Presenters were organized
Please rate the presenters: Presenters were organized Agree
Disagree
Presenters were knowledgeable
Presenters were knowledgeable Agree
Disagree
Presenters held my interest
Presenters held my interest Agree
Disagree
Presenters met the program goal
Presenters met the program goal Agree
Disagree
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9
. I would benefit from more information on this topic.
I would benefit from more information on this topic.
Yes
No
10
. Additional Comments:
Additional Comments:
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