Entities Survey: Module 16
Number of questions: 8
NPDB Reporting
Q 16.1. Have you ever reported to the NPDB on behalf of your organization (without using an authorized agent)?
Yes
No
Other (Please explain) ________
If “yes”, skip to 16.4. Otherwise, go to Q 16.2.
Q 16.2. Has your organization ever reported to the NPDB (without an authorized agent)?
Yes
No
Other (Please explain) ________
If “yes”, go to Q 16.2, go to the next question.
If “no” or “other”, skip to Q 16.4 question about agents.
Q 16.3. As you have not reported to the NPDB, but your organization has, please provide the name and contact information for the person in your organization who submits reports to the NPDB so that they can answer the reports related survey questions.
First name: ____________
Last name: ____________
Telephone number: ____________
Email address: ____________
Skip to Module 19 after Q 16.3. Responses to Q 16.3 will be monitored each week and survey link will be sent to these individuals.
Q 16.4. Does your organization contract with an authorized agent to report adverse actions or judgment or conviction reports to the NPDB?
Yes
No
Other (Please Explain) ___________
Q 16.5. Have you, on behalf of your organization, ever reported any adverse action reports to the NPDB directly (not via an authorized agent)?
Yes
No skip the next question
Other (Please explain) ________ skip the next question
Q 16.6. When was the last time your organization reported an adverse action report to the NPDB (without using an authorized agent)?
In the last 6 months
Between 6 to 12 months ago
Between 1 to 2 years ago
Between 2 to 3 years ago
Between 3 to 4 years ago
More than 4 years ago
Q 16.7. Have you, on behalf of your organization, ever reported any judgment or conviction reports to the NPDB directly (not via an authorized agent)?
Yes
No skip the next question
Other (Please explain) ________ skip the next question
Q 16.8. When was the last time your organization reported judgment or conviction reports to the NPDB (without using an authorized agent)?
In the last 6 months
Between 6 to 12 months ago
Between 1 to 2 years ago
Between 2 to 3 years ago
Between 3 to 4 years ago
More than 4 years ago
Piping logic:
If the respondents report through an agent (“yes” to Q 16.4) but do not report AAR or JOCR directly (not “yes” to either Q 16.5 or Q 16.7), they will be directed to Module 17 and then 19.
If they use agents (“yes” to Q 16.4), submit AAR directly (“yes” to Q 16.5) and submit JOCR directly (“yes” to Q 16.7), they will be directed to Module 17 about agents, then Module 18 about experiences with AAR, then Module 35 about experiences with JOCR, and then Module 19.
If they use agents but also submit AAR directly, but do not report JOCR directly (“yes” to Q 16.4, “yes” to Q 16.5 (AAR), but “no” to Q 16.7), they will be directed to Module 17 about agents next, then Module 18 about experiences with AAR, and then Module 19.
If they use agents but also submit JOCR directly, but do not submit AAR directly (“yes” to Q 16.4, not “yes” to Q 16.5 (AAR), and “yes” to Q 16.7), they will be directed to Module 17 about agents next, then Module 35 about experiences with JOCR, and then Module 19.
If they do not use agents, submit AAR directly, but do not report JOCR directly (“no” to Q 16.4, “yes” to Q 16.5 (AAR), but not “yes” to Q 16.7), they will be directed to Module 18 about experiences with AAR, and then Module 19.
If they do not use agents, submit JOCR directly, but do not submit AAR directly (not “yes” to Q 16.4, not “yes” to Q 16.5 (AAR), and “yes” to Q 16.7), they will be directed to Module 35 about experiences with JOCR, and then Module 19.
If they have not reported themselves (not “yes” to Q 16.1), their organization has (“yes” to Q 16.2) using an agent (“yes” to Q 16.4), they will be directed to Module 17 about agents, then Module 19.
If they do not report directly or through an agent (not “yes” to Q 16.4, Q 16.5 or Q 16.7), they will be directed to Module 19.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-02-15 |