Self Survey Modules
The Division of Health Service Regulation, the North Carolina Health Care Facilities Association and the North Carolina Non-Profit Homes for the Aged originally developed Self Survey Modules in 1997. Committees comprised of providers and regulators assembled modules for nursing home staff to survey themselves on specific regulatory requirements. The modules provide suggested observations, interviews and record reviews for data collection in order to survey one’s own nursing home. Nursing home staff can use these modules as a quality improvement tool.
Sections:
- Tag F164 Privacy and Confidentiality of the Resident (PDF, 18 KB)
- Tag F221 Resident Behavior and Facility Practices (PDF, 31 KB)
- Tag F223 Abuse (PDF, 17 KB)
- Tag F224 Staff Treatment of Residents (PDF, 36 KB)
- Tag F226 Staff Treatment of Residents (PDF, 36 KB)
- Tag F241 Dignity (PDF, 24 KB)
- Tag F242 Self-Determination and Participation (PDF, 18 KB)
- Tag F314 Pressure Sores (PDF, 48 KB)
- Tag F315 Urinary Incontinence (PDF, 63 KB)
- Tag F323 Accidents (PDF, 55 KB)
- Tag F323 Hot Water (PDF, 22 KB)
- Tag F325 Malnourishment (PDF, 26 KB)
- Tag F327 Dehydration (PDF, 39 KB)
- Tag F329 Unnecessary Drugs (PDF, 65 KB)
- Tag F364 Dietary Services (PDF, 23 KB)
- Tag F371 Dietary Services (PDF, 15 KB)
- Tag F498 Proficiency of Nurse Aides (PDF, 18 KB)
