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Nursing Home Investigative Report
Current
Nursing Home: Follow-up Investigation Report
Facility and Case Information
Resident Information Follow-Up
Additional/Updated Information Related to the Reported Incident
Steps taken to investigate the allegation:
Conclusion
Corrective Action(s) Taken
Facility investigator
Submitter Information
1 of 9
Nursing Home: Follow-up Investigation Report
Within five (5) business days of the incident, the facility must provide in its report sufficient information to describe the results of the investigation, and indicate any corrective actions taken if the allegation was verified.
It is important that the facility provide as much information as possible to the best of its knowledge at the time of the submission of the report.
The facility should include any updates to information provided in the initial report and the following additional information, which should include, but are not limited to, the following:
1. Additional/Updated Information Related to the Reported Incident
2. Steps taken to investigate the allegation
3. Conclusion
4. Corrective Action(s) Taken
5. Facility investigator
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