1. List of names for all department heads & key personnel with titles, phone numbers/cell phone numbers, phone extensions, and emails.
2. Who is the backup person for each of your department heads?
3. List of all employees with job titles.
4. Work schedule for each department head - typical times they arrive and leave.
5. Any upcoming vacations for department heads.
6. List of all facility's scheduled meetings with times and location.
7. List of conference calls, call-in numbers, passcodes, and times.
8. Census / census mix information.
9. Resident list with room numbers and payor source.
10. Any Medicaid pending (how long?) and any private pay that haven't paid?
11. List of regional/district/corprate directors/consultants with contact info.
12. List of reports due to whom, by when, and on what form.
13. Chain of command structure (For example - does Medical Records report to the Administrator or the DON? What about MDS?)
14. Current copies of the Policy & Procedure manuals.
15. State reporting contact info - name, phone, fax, form, etc.
16. State regulations - if you haven't already printed them off.
17. What key personnel are new in their role or need additional training?
18. Email and computer access setup.
19. Emergency codes and alarms.
20. Emergency disaster plan and contact numbers.
21. Exit door codes.
22. Facility layout / floorplan.
23. Business cards ordered. (I always get someone else's at the facility and put it by the phone. It'sa quick reference for the address and phone number for the facility until I get them memorized or until my cards come in.)
24. When are pay days?
25. When are scheduled inservices?
26. Office keys / all keys (Let's hope they have a master key system, otherwise, you'll be standing in the hallway for an hour on Friday night going through each of the 200 keys on the giant keyring trying to open the Central Supply door.)
27. Copy of schedules for each department.
28. Who handles operating petty cash?
29. Who handles resident trust petty cash?
30. Tax ID #
31. Medicare #
32. Medicaid #
33. NPI #
34. Facility license #
35. All other numbers...
36. Any special units? Admission criteria?
37. Assignments of department heads & key personnel during survey
38. Copies of the last surveys, POCs, resident identifier lists
39. Where are contracts kept?
40. AR Aging report
41. Resident trust balance report and State SSI limit
42. Rates: Medicaid rate, Medicare RUG rate spreadsheet, copay rate if you don't remember, private pay / semi-private, private pay / prvate room, etc.
43. Managed care contracts and rates
44. Any reportable incidents that have not been investigated by the tate yet?
45. Any reportable incidents that have not been reported yet?!
46. Who is assigned to report? (Everything should always run through you).
47. Copies of the facility's P&L's / financial reports - current and prior.
48. Resident Council - names, officers, minutes
49. Family Council - names, officers, issues
50. Any unresolved grievances?
51. List of residents with physically or sexually aggressive behaviors
52. List of any other "problem" residents
53. List of any "problem" families
54. Medcal Director and Ombudsman contact info
55. Any open workers comp claims? Anyone on restricted duty?
56. Job openings?
57. Wage scales for each department
58. Last QA and safety minutes
59. Meal times
60. Any pending lawsuits or compliance issues?
61. Approved vendors
62. Weight report
63. Skin report
64. QI/QM, last MDS transmission, any default issues
65. Status of each department - plans, goals, projects, obstacles
66. Where's the budget? Expense, revenue, census, and staffing.
67. What capital items do we need / are we waiting on?
68. What types of residents can we take? What do we not take?
69. Updated survey preparation files: