CMS-10630 Audit Survey

Programs of All-Inclusive Care for
the Elderly (PACE)
Audit Survey

PACE Audit Survey

The following survey is voluntary and anonymous. After issuance of the final audit report, PACE
Organizations (POs) will receive a weblink to the survey questions below. The survey is organized
according to pre-audit, audit, and post-audit activities. CMS utilizes survey feedback to improve the audit
process.

Pre-Audit Activities

1. How easy was it to follow CMS’ documentation and universe submission instructions?
1

2

○

○

3

○

4

○

5

6

○

Not Easy

○

7

○

8

○

9

○

Easy

10

○

Very Easy

2. Did you find the information provided in the follow-up call after the audit engagement letter
helpful?

○
○

Yes
No

3. Do you have any suggestions to improve the audit engagement letter follow-up call?

4. Was the Audit Lead available to answer questions prior to the audit?
1

○

2

○

Not Available

3

○

4

○

5

○
Available

6

○

7

○

8

○

9

○

10

○

Always Available

5. How helpful was the Audit Lead in assisting your organization with pre-audit processes such as
documentation submission and universe preparation?
1

○

2

○

3

○

4

○

5

6

○

Not Helpful

○

7

○

8

○

9

10

○

Helpful

○

Very Helpful

6. How many hours do you estimate staff spent collecting, reviewing, and submitting data prior to the
audit?

7. Was the timeframe for submitting documentation and data during the pre-audit portion of the audit
adequate?
1

○

2

○

Not Adequate

3

○

4

○

5

○

6

○

7

○

8

○

Adequate

8. Do you have any additional comments or suggestions regarding the pre-audit process:

9

○

10

○

Very Adequate

Audit Activities
1. Did the audit team members request one or more Root Cause Analyses (RCAs)? If so, how well did the
auditor(s) explain the purpose of the RCA(s) and how to complete them? Enter NA if no RCAs were
requested for a particular element.
SDAG:
NA

○

1

○

2

○

3

○

4

○

Needs Improvement

5

○

6

○

7

○

8

○

Explained Adequately

9

○

10

○

Explained Very Well

Provision of Services:
NA

○

1

○

2

○

3

○

4

○

Needs Improvement

5

○

6

○

7

○

8

○

Explained Adequately

9

○

10

○

Explained Very Well

Personnel:
NA

○

1

○

2

○

3

○

4

○

Needs Improvement

5

○

6

○

7

○

8

○

Explained Adequately

9

○

10

○

Explained Very Well

Compliance and Quality Improvement:
NA

○

1

○

2

○

Needs Improvement

3

○

4

○

5

○

6

○

Explained Adequately

7

○

8

○

9

○

10

○

Explained Very Well

2. How many hours do you estimate staff spent collecting, reviewing, and submitting data from the
start of audit fieldwork through the submission of RCAs?

3. Was the timeframe adequate for submitting documentation and data from the start of audit fieldwork
through the submission of RCAs?
1

○

2

3

○

4

○

5

○

6

○

Not Adequate

7

○

8

○

9

○

10

○

Adequate

○

Very Adequate

4. Did the audit team members request one or more Impact Analyses? If so, how well did the auditor(s)
explain the purpose of the Impact Analyses and how to complete them? Enter NA if there no Impact
Analyses were requested for a particular element.
SDAG:
NA

○

1

○

2

○

3

○

4

○

Needs Improvement

5

○

6

○

7

○

8

○

Explained Adequately

9

○

10

○

Explained Very Well

Provision of Services:
NA

○

1

○

2

○

3

○

4

○

Needs Improvement

5

○

6

○

7

○

8

○

Explained Adequately

9

○

10

○

Explained Very Well

Personnel:
NA

○

1

○

2

○

3

○

4

○

Needs Improvement

5

○

6

○

7

○

8

○

Explained Adequately

9

○

10

○

Explained Very Well

Compliance and Quality Improvement:
NA

○

1

○

2

○

Needs Improvement

3

○

4

○

5

○

6

○

Explained Adequately

7

○

8

○

9

○

10

○

Explained Very Well

5. In order to complete the requested Impact Analyses:
a. How many hours do you estimate it took to complete the requested Impact Analyses?
b. How may staff members do you estimate it took to complete the requested Impact Analyses?

6. During the exit conference, did your organization have a clear understanding of all issues of noncompliance being cited and why they were being cited?

○
○

Yes
No
If you responded No, which issues of non-compliance were not discussed prior to the exit conference (you may
enter any numeric identifier of the issue of non-compliance cited in your audit report or provide a brief
description of the issue)?

7. Do you have any additional comments or suggestions regarding the audit fieldwork process:

Post-Audit Activities

1. How easy was it to understand the Draft and Final Audit Reports?
1

○

2

○

3

○

4

○

5

6

○

Not Easy

○

7

○

8

○

9

10

○

Easy

○

Very Easy

2. How many hours do you estimate staff spent collecting, reviewing, and submitting data following
issuance of the Final Audit Report?

3. Was the timeframe adequate for submitting documentation and data following issuance of the Final
Audit Report?
1

○

2

○

Not Adequate

3

○

4

○

5

○

6

○

7

○

8

○

Adequate

4. Do you have any additional comments or suggestions regarding the post-audit process:

9

○

10

○

Very Adequate

General Audit Questions

1. Please identify any areas or aspects of the audit process that you believe would benefit from
increased transparency or communication.

2. Does the PO’s parent organization operate any additional PACE organizations and/or PACE
contracts?

○
○

Yes
No

If yes, please enter the names and contract numbers of the other PACE organizations.
PACE Organization
Names/Contract Numbers:

3. How would you compare the audit of your PACE organization with the audits of other POs operated
by the same parent organization? Enter NA if the PO’s parent organization does not operate any
other PACE organizations or if the PACE contracts do not compare audit experiences.
NA

○

1

○

2

○

Very Different

3

○

4

○

5

6

○

○
Similar

7

○

8

○

9

○

10

○

Very Similar

4. If you feel that your audit experience was different than other PACE organizations operated by the
same parent organization, please explain how they were different:

5. If you feel that your audit experience was different than other PACE organizations operated by
different parent organizations, please explain how they were different:

6. Are there any other ways you believe we can improve the overall audit process?