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Nursing Home Survey on Patient Safety Culture Data Submission
Definition of a Nursing Home
- A nursing home has licensed nursing home beds and is not an assisted living, community care, or independent living facility.
- Nursing homes must be located in the United States or in a U.S. territory.
What You Will Need for Submission
- Data Use Agreement: Each nursing home is required to sign a Data Use Agreement (DUA) and fax it to 1-888-852-8277.
- Nursing Home Survey on Patient Safety Culture Data Use Agreement (PDF, 142 KB, PDF HELP)
- Nursing Home Survey on Patient Safety Culture Questionnaire(s) Administered: Users will need to upload a copy of the actual questionnaire(s) administered. If you used a copy of the Spanish questionnaire, please upload this questionnaire as well. We will review the submitted questionnaire(s) and users will receive an approved/not approved email within 3 business days.
NOTE: Your questionnaire will not be approved if
- You made changes to any of the questionnaire item text and/or response options.
- You reordered questionnaire items A1−E2.
- You added new questions between items A1 and E2 and did not add new questions at the end of the questionnaire after Section E, before the demographic questions in Section F.
- Nursing Home Site Information: Users can upload nursing home site information in one of two ways, one at a time on the Data Submission Web site or all at once in an Excel spreadsheet.
- Nursing Home Survey on Patient Safety Culture Site-Level Specifications (PDF, 161 KB, PDF HELP)
- Sample Nursing Home Site Information Data File (XLSX, 11 KB)
- Nursing Home Survey on Patient Safety Culture Data: Users will need to upload their Nursing Home survey data, conforming to the Nursing Home Survey on Patient Safety Culture Data Specifications..
- Nursing Home Survey Data Specifications (PDF, 174 KB, PDF HELP)
- Sample Nursing Home Survey Data File (XLSX, 16 KB)
For technical assistance on data submission, email DatabasesOnSafetyCulture@westat.com or call 1-888-324-9790.