Attached are forms that are required to be completed and given to the State Agency during recertification surveys. They are being posted in a format that can be saved and provided to the survey team upon entrance. Please note the Entrance Conference Worksheet for NHA is being provided in addition to a State Entrance Conference Checklist and a SNF Beneficiary Protection Notification form.
Entrance Conference Worksheet for NHA.pdf
SNF Beneficiary Protection Notification.doc
State Entrance Conference Checklist.doc
Survey in Progress Door Sign.pdf