Attachment G: Example Screen Shots of Nursing Home Survey on Patient Safety Culture Data Submission Web Site Information Collection

Attachment G - Example Screenshots of NH SOPS Data Submission Web Site Information Collection.docx

Nursing Home Survey on Patient Safety Culture Comparative Database

Attachment G: Example Screen Shots of Nursing Home Survey on Patient Safety Culture Data Submission Web Site Information Collection

OMB: 0935-0195

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AHRQ Nursing Home Survey on Patient Safety Culture Comparative Database, Supporting Statement B


Attachment G: Example Screen Shots of Nursing Home Survey on Patient Safety Culture Data Submission Web Site Information Collection


Figure 1: Submit Data Use Agreement (DUA) and Link DUA to Medical Office(s)



Figure 1: Submit Data Use Agreement (DUA) and Link DUA to Medical Office(s), continued

Figure 1: Submit Data Use Agreement (DUA) and Link DUA to Medical Office(s), continued

Figure 2: Submit Questionnaire and Link Questionnaire to Nursing Home(s)















Figure 2: Submit Questionnaire and Link Questionnaire to Nursing Home(s), continued













Figure 3: Upload Data File for Each Participating Nursing Home



Figure 3: Upload Data File for Each Participating Nursing Home, continued

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorTheresa Famolaro
File Modified0000-00-00
File Created2021-01-20

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