JCI Accreditation Standards for Long Term Care, 2nd Edition Field Review Full

1. Survey Participant Demographics

Question Title

* 1. Which of the following best describes you?

JCI Field Staff Member (Consultant, Surveyor)

Representative from Long Term Care Organization

Other (please specify)

Question Title

* 2. If you work for a long term care organization, please identify your main role in the long term care organization

Chief Executive Officer (CEO)

Accreditation Survey Coordinator

Senior Leadership (Chief Medical Officer, Chief Nursing Officer, Chief Operations Officer, or equivalent senior leadership position)

Leader of a clinical department or service

Leader of a non-clinical department or service

Medical staff member

Nursing staff member

Quality improvement or risk management director/leader

Quality improvement or risk management staff member

Other (please specify)

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* 3. If you answered question 2, which of the following best describes your organization?

Privately-owned long term care organization

Publicly-owned long term care organization (for example, MOH)

Other (please specify)

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* 4. Please identify which services are provided by your organization? (Check all that apply)

Physical/Occupational therapy

Palliative care

Hospice care

Elder care

Pediatric care

Drug/Addiction services

Complex care (i.e. management of patients on ventilators)

Dementia/Memory care

Other (please specify)

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* 5. In which geographic location is your organization located

Africa

Americas

Asia

Asia-Pacific

Caribbean

Europe

Middle East/Gult

Other (please specify)

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* 6. What is your organization's name (Optional)

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* 7. Please indicate your organization's accreditation status

Accredited by JCI

Not accredited by JCI

Prefer not to answer

Accredited by another accrediting organization (Please specify)