Screen Reader Mode Icon
Purpose:

The purpose of this questionnaire is to gather information to identify how nursing homes are using resident and family satisfaction surveys to improve quality. The information gathered through this solicitation may be used to develop programs and policies aimed at improving resident and family satisfaction outcomes, and how those outcomes can be used to improve quality.

Background:

New York regulates over 620 nursing homes throughout the State, with approximately 100,000 New Yorkers residing in nursing homes. The Department of Health (Department) recognizes the importance of ensuring that all New Yorkers residing in nursing homes receive quality care.

The Department is very interested in any initiative targeted at improving nursing home quality. This questionnaire is one of the first steps in a series of projects that will seek to gain valuable input on how to improve nursing home quality across the State.  

Information Request:

The Department is seeking information from nursing home providers. Of particular interest is feedback from providers that are currently or have previously undertaken quality improvement initiatives developed from the results of resident and family satisfaction surveys. Providers should submit information and data on best practices currently in use and recommendations on how to effectively and efficiently implement successful quality improvement programs.  We are seeking only one response per nursing home.
Please have the Chief Information Officer (CIO), or equivalent title with decision making authority over IT matters, fill out the survey. 

Your time and input are greatly appreciated.

Questions should be sent to: ALTCteam@health.ny.gov 

Your response is required by September 20, 2019.

 



 



 

 

Question Title

* 1. Facility Name

Question Title

* 2. Address of Facility

Question Title

* 3. Permanent Facility ID

Question Title

* 4. Facility Status (for-profit, not-for-profit, county)

Question Title

* 5. Hospital System Affiliation 
*Please note that affiliation means user or directly related to a hospital EMR system

Question Title

* 6. Total Number of Certified Beds

Question Title

* 7. Percentage of patients in sub-acute beds.

Question Title

* 8. Percentage of patients in long-term care/custodial beds.

Question Title

* 9. If residents and/or families are not surveyed, describe why not.

Question Title

* 10. Provide the most recent year in which your facility surveyed residents and/or families.

Question Title

* 11. Does your facility survey the full facility population or a sample?

Question Title

* 12. If only surveying a sample population, how is the sample selected and what is the proportion of the total facility population?

Question Title

* 13. Does your facility administer surveys through a third-party? 

Question Title

* 14. If not surveyed through a third-party, how are surveys administered?

Question Title

* 15. Are surveys administered via phone, e-mail, in-person, or a combination?

Question Title

* 16. Are residents assisted with survey completion? If yes, by whom? 

Question Title

* 17. What is the average survey response rate?

Question Title

* 18. How often are residents and/or families surveyed?

Question Title

* 19. How does facility staff review survey results to develop quality initiatives?

Question Title

* 20. What approaches are used to address the issues identified in the survey?

Question Title

* 21. Are any of the approaches used evidence-based? If yes, describe the 
approaches used.

Question Title

* 22. What are the top three quality initiatives being addressed?

Question Title

* 23. How are facility improvement activities aligned with State and federal quality standards and the State's Nursing Home Quality Initiative?

Question Title

* 24. How are residents and/or families engaged in the quality improvement 
activities being undertaken?

Question Title

* 25. Is there any other information that you would like to share that would be 
helpful to the Department? 

0 of 25 answered
 

T