ODHS Complaint and Licensing Survey Questionnaire

The Oregon Department of Human Services (ODHS) Safety Oversight and Quality teams are resuming in person assisted living/residential care licensing surveys, nursing facility complaint investigation surveys and very limited nursing facility re-licensing surveys.

OHCA is collecting survey process related information to evaluate member experiences and the consistency of the survey process. Please answer the questions below and contact OHCA, lindak@ohca.com, with questions.

All individual response data will be kept confidential and will only be presented in the aggregate.

Question Title

* 1. Contact Information

Name

Facility/Organization Name

Building Census (what percent are you fully occupied)

Title

Email Address

Facility Type (ALF, RCF, NF, MCC)

Question Title

* 2. Has your facility (or facilities if a corporate office) experienced a survey or investigation in the previous month?

Yes