JOB TITLE: HEALTH CARE NURSE SURVEYOR

JOB CODE: 39241

SERIES NATURE OF WORK: The Health Care Surveyor job series describes work surveying health care entities for compliance with federal Medicare/Medicaid and state licensure laws and regulations.

DEFINITION: This is professional regulatory work surveying, licensing, and certifying health care entities to ensure patient care and services meet state and federal standards.

An employee in this job conducts on-site surveys by observing health care service delivery, interviewing staff and clients, and reviewing medical records to ensure patients receive safe and appropriate care and services. Work involves providing findings to facility administrators and staff, identifying potential citations, and reviewing plans of correction in response to deficiencies. Work includes providing clinical nursing recommendations during the survey process and in consultation with facility leadership. Work also involves investigating complaints and incidents; providing information to facilitate regulatory compliance; and reviewing certification, licensure, and registration applications for completeness and accuracy. Important aspects of the work include the review and analysis of data to determine if the health care entity is meeting standards of care, documenting survey findings, and making recommendations to issue or renew a state license or federal certification. Employees in this job may serve as a team leader for independent surveys and surveys that require the collaboration of an interdisciplinary survey team. Work is performed under the general direction of a Health Care Surveyor Supervisor, who evaluates work for adherence to program objectives.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.)

• Evaluates the delivery of services that contribute to the quality of life for patients and conducts interviews with facility staff and clients to gather information on facility operations.

• Analyzes facility records including policies and procedures, committee meeting minutes, administrative records, personnel files, and patient medical records.

• Assesses compliance and safety by conducting physical inspections of facilities, including patient care, living areas, kitchens, pharmacies, and laundry areas.

• Advises health care entities, administrators, and providers of deficiencies or adverse actions based on results of on-site surveys, resurveys, or investigations.

• Prepares and analyzes reports detailing findings and recommendations for continued licensure and certification of health care entities.

• Assembles and leads survey teams; coordinates survey preparation, assignments, communication, and reports of findings; conducts entrance and exit conferences; and develops recommendations for supervisory review for licensure and certification.

• Assesses incidents or complaints and assigns their priority level; communicates with complainants, health care facility administrators, and providers to gather and record information; determines reportable incidents; prioritizes follow-up; and recommends on-site investigations.

• Prepares and provides testimony at hearings regarding health care providers found to be deficient or non-compliant with standards.

• Examines surveys, investigations, recommendations, and applications for completeness and accuracy; reviews and processes change of ownership applications, exception requests, and other survey-related documentation; and prepares correspondence.

• Investigates allegations of abuse, neglect, or misappropriation of property by nurse aides; tracks criminal charges; and prepares recommendations for retention or removal of the employee from the state registry.

• Travels to field sites to conduct surveys and investigations.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of the laws, rules, and regulations governing standards of patient care.

• Knowledge of quality-of-care requirements for health care providers.

• Knowledge of data collection methods.

• Knowledge of the use and functionality of Microsoft Office Suite software.

• Ability to analyze and interpret numerical data.

• Ability to analyze and interpret health facility charts and records.

• Ability to analyze and interpret rules, regulations, policies, and procedures.

• Ability to operate a motor vehicle.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

• Ability to establish and maintain effective working relationships.

SPECIAL REQUIREMENTS:

• All positions require successful completion of the relevant provider-specific federally mandated Surveyor Minimum Qualifications training and Test (SMQT) provided by the Centers for Medicare and Medicaid Services or an equivalent certifying body for the discipline, within one year of hire.

• All positions require active authorization to practice as a Registered Nurse in Pennsylvania.

• All employees possessing an active temporary practice permit must obtain licensure as a Registered Nurse within the one (1) year period defined by the Pennsylvania State Board of Nursing.

• All positions require possession of an active motor vehicle license.