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Nursing Home Ownership Survey
Dear Nursing Home Administrator:
The Department of Health is requesting your assistance in the development of an up-to-date database of all individuals responsible for the governance of nursing homes in New York State. Please note that the information you provide in this survey must be accurate and correspond with the information reported to the Centers for Medicare and Medicaid Services, the Department of State’s Charities Bureau in your facility’s annual 990, and/or any other state or federal agency.
Directions
All nursing home facilities must complete questions 1-5.
Not-for-profit Nursing Homes
Please provide the name and contact information (professional email address and phone number) of your Board of Director's President and all Board members.
For-profit Nursing Homes
Please provide contact information for individuals possessing an ownership interest in your nursing home.
Please complete the survey no later than Friday, June 5, 2020 at 3:00 p.m.