"Designing the Age Friendly Health Care Workplace" CNO Survey

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* 1. Which of the following best characterizes your facility (select all that apply)?

Teaching (Academic)

Private, For Profit

Private, Not For Profit

Public

Long Term Care

Other (please specify)

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* 2. How many beds is your facility licensed to occupy?

0-100 beds

101-300 beds

301-500 beds

More than 500 beds

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* 3. How many employees do you have at your facility?

250 or less

251-500

501-750

751-1000

1001-1250

1251-1500

1501-1750

More than 1751

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* 4. What is the total number of direct care providers at your facility?

250 or Less

251-500

501-750

751-1000

1001-1250

1251-1500

1501-1750

More than 1751

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* 5. Employees and providers over age 45.

a. What proportion of the total number of employees is over the age 45?

b. What proportion of direct care providers are over the age 45?

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* 6. Does your facility offer any of the following programs/ activities? (Mark all that apply)

a. Smoking cessation

b. Health coaching

c. Health risk appraisal

d. Elder care

e. Child care

f. On site fitness center

g. Employee assistance program (EAP)

h. Flexible work arrangements

i. Employee continuing education benefits

j. Academic degree tuition benefits (for employee)

k. Academic degree tuition benefits (for family members)

l. Human factors/ ergonomics

m. Employee health clinic

n. No

Other (please specify)

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* 7. Does your facility have specific initiatives to address the health needs of older workers? If yes, please describe.

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* 8. Does your facility provide training and education to meet the needs of the aging workforce?

Yes (Please provide examples below)

No (Please comment below)

Examples or Comments:

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* 1. Which of the following best characterizes your facility (select all that apply)?

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* 2. How many beds is your facility licensed to occupy?

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* 3. How many employees do you have at your facility?

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* 4. What is the total number of direct care providers at your facility?

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* 5. Employees and providers over age 45.

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* 6. Does your facility offer any of the following programs/ activities? (Mark all that apply)

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* 7. Does your facility have specific initiatives to address the health needs of older workers? If yes, please describe.

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* 8. Does your facility provide training and education to meet the needs of the aging workforce?

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* 9. Additional comments welcome. If you have a particular interest in the topic of the aging workforce, can you please share it with us?