Form Cms-806b - Quality Of Life Assessment - Group Interview (Page 4 of 4) in pdf

Form Cms-806b - Quality Of Life Assessment - Group Interview Page 4

GROUP INTERVIEW

11. COUNCIL: (F243)

(If you are speaking with a resident council)

How does the council communicate its concerns to the

Does the facility help you with arrangements for council

facility?

meetings?

How does the administrator respond to the council's

Do they make sure you have space to meet?

concerns?

Can you have meetings without any staff present if you

If the facility cannot accommodate a council request, do

wish?

they give you a reasonable explanation?

12. GRIEVANCES: (F165, 166)

Have any of you or the group as a whole ever voiced a

Do you feel free to make complaints to staff? If not, why

grievance to the facility?

not (probe for specific examples)?

How did staff react to this?

Did they resolve the problem?

13. Identify here any issues you would like to discuss with the group that have not been covered in the questions

above.

14. Is there anything else about life here in the facility that you would like to discuss?

Thank the group for their time. After the interview, follow up on any concerns that need further investigation. Document

your follow up on Resident Review or Supervisor Notes Worksheets. Share these concerns with the team.

Form CMS-806B (07/95)

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Form Cms-806b - Quality Of Life Assessment - Group Interview Page 4