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Summary of the Division of Quality Assurance Provider Post-Survey Questionnaire

PDF Version of DQA 11-014  (PDF, 44 KB)

Date: May 16, 2011 -- DQA Memo 11-014
To: Adult Day Care ADC 02
Adult Family Homes AFH 04
Ambulatory Surgery Centers ASC 04
Certified Mental Health and AODA Programs CMHA 03
Clinical Lab Improvement Amendments CLIA 02
Community Based Residential Facilities CBRF 07
End Stage Renal Dialysis Units ESRD 04
Facilities for the Developmentally Disabled FDD 04
Home Health Agencies HHA 02
Hospices HSPCE 04
Hospitals HOSP 05
Nursing Homes NH 09
Outpatient Rehabilitation Facilities OPT/SP 02
Personal Care Providers PCP 02
Residential Care Apartment Complexes RCAC 04
Rural Health Clinics RHC 02
From: Alfred C. Johnson, Director
Bureau of Technology, Licensing and Education

Otis Woods, Administrator
Division of Quality Assurance

Summary of the Division of Quality Assurance Provider Post-Survey Questionnaire

The purpose of this memo is to share information regarding the results and use of the Division of Quality Assurance Post-Survey Questionnaire and to encourage all providers to utilize this tool to give the Division constructive feedback on the survey process.

The Division has utilized the Post-Survey Questionnaire since 2004. The survey was originally distributed to providers directly by surveyors when on-site surveys were conducted.

Starting in 2006, the Division implemented an online method of completing the questionnaire at

The following table summarizes the questionnaire responses received by the Division during the past five years.

Division of Quality Assurance Post Survey Questionnaire, Summary Results, CY 2006 to 2010


Overall Ratings (5 = Highest, 1 = Lowest)



Questionnaires Completed

On-Site Survey Process

Statement of Deficiency

% Satisfied with Survey Task Performance

2006 442 4.50 4.34 98.47
2007 436 4.54 4.35 97.42
2008 272 4.09 4.15 96.86
2009 208 4.46 4.25 97.05
2010 245 4.54 4.36 96.71

While providers' ratings of the survey process and statements of deficiency, and their level of satisfaction with survey task performance, have remained high throughout this period, these figures are based on responses from a relatively small and generally declining proportion of the providers that have actually been surveyed.

The Division encourages all providers to complete the questionnaire, and to provide feedback about your experiences with DQA's review. While the Division appreciates the generally high marks providers have given, responses indicative of less-than-satisfactory survey performance are actually the most useful when it comes to identifying opportunities for improvement, enhancing communication and training that often requires immediate follow-up.

The Division is committed to using the feedback received through the Post-Survey Questionnaire to improve the survey process in general and address any issues that will aid in staff performance as well as provider understanding of the survey process.

The Division of Quality Assurance is committed to continuous quality improvement. We expect it from the providers we regulate and we expect it of ourselves. We will use the information facilities submit to us through this questionnaire to review, revise and improve Division systems and practices.

Respondents may remain anonymous, and reports of the questionnaire results never include the identity of individual providers/facilities. While completion of the questionnaire is voluntary, your participation is vital; we need and want to hear from you.

If you have any questions related to the questionnaire or the results reported here, please contact Alfred Johnson at (608) 266-2055 or at Thank you.


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Last Updated: September 30, 2011