ASPEN Reports
Report Name File Name Summary Access New in Release ACO / ARO Reports (39 Total) Administrator Facility History AdminFacHistory.rpt Lists the facilities where selected *Reports → Administrator reports → (AFH) report administrators have been employed. It Administrator Facility History (AFH) (Accessible from multiple paths) includes identifying information for each *Directory View - Administration Directory → - facility and the administrator’s active dates at (Right click an administrator) Quick Report → the facilities Administrator Facility History (AFH) Administrator Survey Performance SurveyPerformHistory.rpt Provides information about the surveys that *Reports → Administrator reports → (ASP) report have been conducted at facilities where Administrator Survey Performance (ASP) (*Accessible from multiple paths) selected administrators are or have been *Directory View - (Right click an administrator) - associated. Quick Report → Administrator Survey Performance (ASP) FMS Transactions Report (All FMSTracking.rpt RO Mode only. Displays only those Tracking → FMS Tracking… → FMS Reports Failed FMS transactions without transactions for Federal Monitoring Survey Drop-down - All Failed FMS transactions without - success) (FMS) cases in a current failed state since success the last successful upload. FMS Transactions Report (All FMSTracking.rpt RO Mode only. Lists all cases in Federal Tracking → FMS Tracking… → FMS Reports FMS transactions) Monitoring Survey (FMS) tracking, including Drop-down - All FMS transactions - FMS Type, Extent, Event IDs, and pending upload status. FMS Tracking report (ARO FMS FMSTracking.rpt RO Mode only. Displays the information in Tracking → FMS Tracking… → FMS Reports Tracking Report) the Federal Monitoring Survey (FMS) Drop-down - FMS Tracking Report - Tracking window in report form, including Transaction details and upload status. ASPEN Severity/Scope Grid OneSurvSS.rpt Presents all of the Scope/Severity details for Cert/Survey View → Expand Other Surveys - report a selected survey, in grid format. Survey Type → (Right Click) Specific Survey → - Print Forms... → S/S Grid
Certification Kit Report CertKit.rpt Displays list of facility Certification Kits, with Tracking → Certifications → Print Tracking an option of sorting the data in ascending or Report - descending order alphabetically, or by survey date.
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Report Name File Name Summary Access New in Release Facility Branch (FB) report Branch.rpt Lists the specific facility and details of any Expand Facility → (Right-click) Affiliations node branches that are associated with that facility. → Quick Report → Facility Branch (FB) -
Facility Report Selection Criteria oFacdir.rpt Lists facilities with details about each. Reports → Facility Reports → Facility Report (Facility Directory (FD)) Including identifying information, emergency Selection Criteria - contact, and operating status.
Facility Information (FI) report oFacInfo.rpt Provides details from the facility record, (Right click) Facility Node → Quick Report → including any buildings associated with the Facility Information (FI) - facility. Facility List (FL) report FacilityList.rpt Line summary of information for facilities in My Selections Node → (Right click) Selection (Facility Quick List (FL) the highlighted selection set. Set → Quick Report → Facility List (FL) - Full Facility Profile (FFP) report FacSurv.rpt Includes information about selected facility, Facility Node → Quick Reports → Full Facility administrators, and branches, with survey Profile (FFP) - performance details. HHA Branch Report HHABRANCH.rpt Lists details for Home Health Agency (HHA) Reports → Facility Reports → Provider (Home Health Agency Providers facilities that have Branches defined. Affiliations → HHA Branch Report - with Branches Defined) Hospital/CAH Medicare (And FormWKST.rpt In-house worksheet that shows general Certification Kit → Application Worksheet → Medicaid - If Applicable ) Database information about the facility, CLIA numbers, Print - Worksheet and accreditation status. Hospital Offsite and Affiliation HospOffsiteAffiliation.rpt Lists details for hospital providers with offsite Reports → Facility Reports → Provider Report and affiliation locations. Affiliations → Hospital Offsite and Affiliations - (Hospital Providers with Offsite Report and Affiliation Locations) NPI By Number report NPINumber.rpt Displays facility details and National Provider Reports → NPI Reports → NPI By Number Identifier (NPI) numbers in ascending order - by NPI number. NPI By Provider report NPIProvider.rpt Displays facility details and National Provider Reports → NPI Reports → NPI By Provider Identifier (NPI) numbers in ascending order - by CMS Certification Number.
OPT Extensions Report OPD_Extension.rpt Lists the Outpatient Physical Therapy (OPT) Reports → Facility Reports → Provider (Outpatient Physical Therapy providers with extension locations Affiliations → OPT Extensions Report Providers with Extension Location) information, including any approved/opened, - terminated, and accepted data.
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Report Name File Name Summary Access New in Release Owner Facility History (OFH) OwnerFacHistory.rpt Lists the facilities owned by selected owner *Reports → Owner Reports → Owner Facility report companies currently and in the past, including History (OFH) (*Accessible from multiple paths) identifying information for each facility and the *Directory View - Ownership Directory → (Right - owner company’s dates of ownership. click an organization) Quick Report → Owner Facility History (OFH)
Owner Survey Performance (OSP) OwnerSurveyPerform.rpt Provides information about the surveys that *Reports → Owner Reports → Owner Survey report have been conducted at facilities owned by Performance (OSP) (*Accessible from multiple paths) selected owner companies. *Directory View - Ownership Directory → (Right - click an organization) Quick Report → Owner Survey Performance (OFH) Personnel Master List (PML) oPersons.rpt List of staff members with contact Directory View - (Right click) Staff Directory → report information. Quick Report → Personnel Master List (PML) - Quick Report oQuickRpt.rpt Multiple options. Displays selected Survey Node → (Right click) Survey → Print - information for a specific survey. Forms → Quick Report Regulation Set (RS) report oRegSet.rpt Displays properties, definitions, interpretive Regulation - Active Only Node → (Right-click) guidelines and, optionally, custom help, for Quick Reports → Regulation Set (RS) - each tag in the selected regulation set. Report Usage Summary ReportUsageSummary.rpt Displays list of dates/times printed for all Reports → Report Usage Summary ACO/ACTS reports by ID number and name. The SA Report Usage Summary report displays the data for the current state. The - RO Report Usage Summary report provides the option to display data for the current state or for all states. Severity/Scope Detail (SSD) report SSSummary.rpt Shows the distribution of citations by Reports → Survey History Reports → (Scope/Severity Detail SSD) severity/scope rating during the given time Severity/Scope Detail period, and indicates the facility(s), survey - event ID, survey date, and surveyor for each citation. Severity/Scope Summary (SSS) SSSummary.rpt Summarizes the distribution of citations by Reports → Survey History Reports → report (Scope/Severity Summary severity/scope rating during the given period Severity/Scope Summary - SSS) of time. Citation Detail (STF2) report (Staff CitationDetail.rpt Includes all information in the Survey *Reports → Surveyor Reports → Citation Detail Citation Detail (STF2) - Summary report as well as a list of tags cited (STF2) - Accessible from multiple paths) by each surveyor. *Directory View - (Right Click) Staff Directory → Quick Report → Citation Detail (STF2)
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Report Name File Name Summary Access New in Release Tag Frequency (STF3) report TagFrequency.rpt Lists tags cited by selected surveyors during *Reports → Surveyor Reports → Tag Frequency (Staff Citation Frequency (STF3) the given time period and shows citation (STF3) - Accessible from multiple paths) frequency along with severity and scope. You *Directory View - (Right Click) Staff Directory → - can choose to sort by tag ID or by frequency. Quick Report → Tag Frequency (STF3)
Survey Summary (STF1) report SurveySummary.rpt Presents summary information for surveys *Reports → Surveyor Reports → Survey (Staff Survey Summary (STF1) - conducted by selected surveyors during the Summary (STF1) Accessible from multiple paths) specified period of time. Does not include *Directory View - (Right Click) Staff Directory surveys with only 0000, 9999, or 9999K tags → Quick Report → Survey Summary (STF1) - OR tags that have been corrected in subsequent surveys, or surveys where no citations were cited by selected surveyor. Tag Details (TAG2) report TagDetail.rpt Includes all information in the Tag Summary Reports → Regulation Reports → Tag Details (Tag Detail Report (TAG2)) report as well as the surveyor who issued (TAG2) each citation and percentage of total citations - for the tag issued by that surveyor.
Tag Summary (TAG1) report TagSummary.rpt Lists the number of citations issued during the Reports → Regulation Reports → Tag Summary specified time period for selected regulations. (TAG1) Average severity and scope are also listed for - each citation. Transactions Report TransactionTracking.rpt Lists upload transactions for a specified Tracking → Transactions → OK → PRINT period. There are numerous selection options for transactions, including an RO quick list of - initial and flagged kits. Transactions Report - CLIA - All TransactionTracking_CLIA.rpt Lists upload transactions for which CLIA Tracking → Transactions → (Drop-down menu) Failed Transactions without a uploads failed and the follow-up action was CLIA - All Failed Transactions without a Follow- - Follow-up Success unsuccessful during a specified period. up Success option → PRINT Work Unit Roster (TR) report TeamRoster.rpt Provides details about the selected Work Unit Directory View → (Right click) Work Unit Node - and a list of its members, with details from the or- (Right click) specific Work Unit → Quick employee file. You can generate the report for Report → Work Unit Roster (TR) - all Work Units as well.
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Report Name File Name Summary Access New in Release (Letter Title Specific) By Group Allows you to view/generate a letter from the Reports → Form Letters → By Group… - letter directory for a group of recipients; - Based on select facility information. (Letter Title Specific) Custom Allows you to view/generate a letter from the Reports → Form Letters → Custom Select… - letter directory for selected facility recipients. - Batched Letters for
Surveyor Notes LTCSPSurveyorNotes.pdf Lists all surveyors by name (last name, first ACO → NH → Surveys → right-click a survey → name) and ID. Lists any notes surveyors LTCSP Documentation Reports (confidential) → 11.2 recorded. Surveyor Notes Team Meeting Notes LTCSPTeamMeetingNotes.pdf Lists the full text of the LTCSP application, ACO → NH → Surveys → right-click a survey → including indication of date option (day1, LTCSP Documentation Reports (confidential) → day2, or later), values entered by the TC, and Team Meeting Notes 11.2 any available notes.
Initial Pool Data LTCSPInitialPool.pdf Lists Care Area descriptions, RI, RRI, RO ACO → NH → Surveys → right-click a survey → and RR responses for each Care Area, LTCSP Documentation Reports (confidential) → including blank responses, documentation for Initial Pool Data 11.2 each Care Area, and MDS Discrepancy, if checked.
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Report Name File Name Summary Access New in Release Resident Investigation Data LTCSPInvestByInvest.pdf Lists residents investigations. If sorted by ACO → NH → Surveys → right-click a survey → Investigative Area (default), report is sorted LTCSP Documentation Reports (confidential) → by investigative area with associated Resident Investigation Data residents (last name, first name) under that 11.2 area. If sorted by Resident, report is sorted by resident (last name, first name), with associated investigations listed. Facility Task Data LTCSPFacilityTask.pdf Lists Facility Tasks, the surveyors (name and ACO → NH → Surveys → right-click a survey → ID) assigned to the Facility Task, and the LTCSP Documentation Reports (confidential) → 11.2 residents (last name, first name). Facility Task Data Potential Citation Data LTCSPPotentialCite.pdf For Cited and Non-Cited Tags, displays ACO → NH → Surveys → right-click a survey → - Tag , tag description and scope severity LTCSP Documentation Reports (confidential) → - Investigative areas and residents where CE Potential Citation Data response was No - Residents that were selected for inclusion (last name, first name, (ID) - Surveyor who performed the investigation 11.2 (last name, first name (ID)) - Severity for the specific resident / CA with description Additionally, for Non-Cited tages, displays the reason/rationale for not citing. Federal Monitoring Survey LTCSPFMSurvey.rpt RO Mode only. Lists deficiency information ARO → NH → Surveys → right-click survey → Documentation Report from SA/RO surveys. Including, initial pol, LTCSP Documentation Reports (confidential) → sample selection, investigation, and facility Federal Monitoring Survey 11.5 task results.
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Report Name File Name Summary Access New in Release STAR Reports (6 Total) Surveyor Page Notes Survey STARSurveyorNotes.rpt Displays details of any notes created by Cert/Survey View → STAR Survey (Right Click) Documentation Report surveyors in the Page Notes section of the STAR Reports (confidential) → Surveyor Page - associated STAR survey. Notes option Staff List Survey Documentation STARStaffList.rpt Displays survey team members and names of Cert/Survey View → STAR Survey (Right Click) Report those interviewed for the survey. Also STAR Reports (confidential) → Staff List option - includes the facility name, event ID, and survey exit date Patient List Survey Documentation STARPatientList.rpt Displays a list of patient names and labels Cert/Survey View → STAR Survey (Right Click) Report interviewed for the survey. Also includes STAR Reports (confidential) → Patient List - facility name, event ID, and survey exit date. option Survey Data Survey STARSurveyData.rpt Displays full survey data grouped by surveyor, Cert/Survey View → STAR Survey (Right Click) Documentation Report including question text, answers, findings, STAR Reports (confidential) → Survey Data - tags, and whether the answer indicates a option concern. Potential Citation Data Survey STARPotentialCitations.rpt Lists tag information, including tag ID, tag Cert/Survey View → STAR Survey (Right Click) Documentation Report title, number of times triggered, and whether STAR Reports (confidential) → Potential Citation or not tag was cited. For cited tags, includes Data option - STAR citation write-up data. Report Summary Survey STARReportSummary.rpt This report prints every time one or more of Cert/Survey View → STAR Survey (Right Click) Documentation Report the Survey Documentation sub-reports are STAR Reports (confidential) → Any STAR Data generated, and displays the following option information: CCN, facility name and address, - survey exit date, STAR data, each sub-report with a Yes/No indicator of whether the report was generated, and the criteria used for generated sub-reports.
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Report Name File Name Summary Access New in Release AST Reports (30 Total) Pending/Initial Aging Report AST_PendingAging.rpt Provides facility name, address, type, phone, Reports → Scheduling & Tracking Reports → History email, and active date information for a Tracking Report → Pending/ Initial Aging Report - selected administrator. Branch Office report HHABranch1.rpt Provides basic information on the branch Reports → Scheduling and Tracking Reports → offices associated with an HHA, as entered Profile Reports → Branch Office - on CMS-1572A. Schedule Calendar Report ASTCalendar.rpt Lists scheduled certifications and AST → Calendar → Print → Schedule Calendar recertifications in a standard calendar format. Report -
Facility Milestone report AST_Milestones.rpt Details all of the certification milestones for Reports → Scheduling & Tracking Reports → the user-selected facilities, including provider, Tracking Report → Facility Milestone survey, IDR, 2567, and POC tracking - information. Also includes information regarding any Transfer to OSCAR (Upload) transactions. Certifications to be Scheduled AST_CertToBeScheduled.rpt Lists facilities/providers with certifications yet Reports → Scheduling & Tracking Reports → report to be scheduled, including most recent and Scheduling Reports → Certifications to be - target certification survey dates. Scheduled Change of Ownership Profile AST_ChowProfile.rpt Detailed process of selected facility/provider Reports → Scheduling & Tracking Reports → report (Change of Owner Tracking ownership changes. Profile Reports → Change of Ownership Profile - Profile) CHOW Tracking report AST_ChowChangeOwner Provides the Change of Ownership (CHOW) Reports → Scheduling & Tracking Reports → Tracking.rpt processing steps for a facility/provider. Tracking Report → CHOW Tracking -
CHOW Processing Time report AST_ChowProcessTimes.rpt Defines the average number of days elapsed Reports → Scheduling & Tracking Reports → during the steps required for change of Tracking Report → CHOW Processing Time - ownership (CHOW) processing.
Complaint to be Scheduled report AST_CompToBeScheduled.rpt Lists information about intakes requiring a Reports → Scheduling & Tracking Reports → (Complaint Investigations to be complaint investigation that is not yet Scheduling Reports → Complaints to be - Scheduled) scheduled, including provider/facility and Scheduled complainant information. Tracking - Comprehensive report AST_ComprehensiveSS.rpt Lists a scheduling report of all comprehensive Reports → Scheduling & Tracking Reports → (Comprehensive Survey surveys for selected time frame, including Tracking Report → Tracking-Comprehensive Scheduling Report) provider & facility information, most recent - and target certification dates, and number of pending complaints.
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Report Name File Name Summary Access New in Release CoPs Out of Compliance report AST_CoP.rpt Details out-of-compliance conditions of Reports → Scheduling & Tracking Reports → participation (COPs) for each selected facility. Tracking Report → CoPs out of compliance -
Full Facility Profile (FFP) report oFacSurv.rpt Profile report presents comprehensive Reports → Scheduling and Tracking Reports → information about each facility/provider Profile Reports → Full Facility Profile (FFP) selected for the report, including basic facility - properties information and survey performance history. Survey Overdue (HHA) report AST_HHASurveyOverdue.rpt Details Home Health Agencies (HHAs) that Reports → Scheduling & Tracking Reports → are overdue for a survey. Tracking Reports → Survey Overdue (HHA) - Initial Certification Processing AST_CertificationProcessTimes. Details the average number of days elapsed Reports → Scheduling & Tracking Reports → Time report rpt for specific actions during initial certification Tracking Reports → Certification Processing - processing, including number of sampled Time → Initial Certification Processing Time providers. Initial Certification Profile report AST_InitialCertProfileSA2.rpt Provides information and status on the Reports → Scheduling & Tracking Reports → (Initial Provider Certification certification process for the providers selected Profile Reports → Initial Certification Profile - Tracking Profile) for the report. Involuntary Termination 23 Day AST_InvolutaryTermination23. Lists providers involuntarily terminated within Reports → Scheduling & Tracking Reports → report rpt 23 days of being notified of non-compliance. Tracking Reports → Involuntary Termination 23 -
Involuntary Termination 90 Day AST_InvolutaryTermination90. Lists providers involuntarily terminated within Reports → Scheduling & Tracking Reports → report rpt 90 days of being notified of non-compliance. Tracking Reports → Involuntary Termination 90 -
Termination (90 Days) report AST_Termination.rpt Lists providers terminated within 90 or 23 Reports → Scheduling & Tracking Reports → Termination (23 Days) report days, respectively, of non-compliance Profile Reports → Involuntary Termination (90 (Involuntary Termination (90 notification. Days) / (23 Days) - Days)) / (Involuntary Termination (23 Days)) Months Since Last Certification AST_MonthsSinceLastCert Lists facility/provider information and the date Reports → Scheduling and Tracking Reports → report Report.rpt of their most recent certification, including Scheduling Reports → Months Since Last time interval, and the date the current Certification - certification (If applicable) is scheduled or in progress. Overdue Revisit report AST_RevisitOverdue.rpt Details of facilities that have an overdue Reports → Scheduling & Tracking Reports → required revisit. Tracking Reports → Overdue Revisits -
Recertification Processing Times AST_ReCertificationProcess Details the average number of days elapsed Reports → Scheduling & Tracking Reports → report Times.rpt for specific actions during recertification Tracking Reports → Certification Processing - processing, including the number of sampled Time → Recertification Processing Time providers.
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Report Name File Name Summary Access New in Release Recertification Profile report AST_RecerCertProfileSA.rpt Provides recertification status and information Reports → Scheduling & Tracking Reports → (Recertification Provider for each provider selected for the report. Profile Reports → Recertification Profile - Certification Tracking Profile) Revisits to be Scheduled report AST_RevToBeScheduled.rpt Details of facilities that require revisit surveys Reports → Scheduling & Tracking Reports → that are not yet scheduled. Scheduling Reports → Revisits to be Scheduled -
Scheduled Surveys by Facility AST_ScheduleDetail.rpt Provides details of scheduled surveys and *Reports → Scheduling & Tracking Reports → (*Schedule Detail Report - survey team for a user-defined period. Scheduling Reports → Scheduled Survey Report Accessible from multiple paths) by Period → Scheduled Surveys by Facility - *AST → Calendar → Print → Schedule Detail Report
Scheduled Surveys by AST_ScheduleSurveyor.rpt List of surveys currently scheduled by either Reports → Scheduling and Tracking Reports → Surveyor/Team report surveyor or survey team. Scheduling Reports → Scheduled Survey Report - By Period → Scheduled Surveys by Surveyor/Team Survey Average Report AST_SurveyAverageInterval Details the number of months since the last Reports → Scheduling & Tracking Reports → (Survey Average Interval Report) Report.rpt certification for a user-defined set of providers Scheduling Reports → Survey Average Report - and time parameters. Surveys Awaiting Acceptable Plan AST_POCTracking.rpt Lists facilities that have received at least one Reports → Scheduling & Tracking Reports → of Correction report survey indicating deficiencies, and have yet to Tracking Reports → POC Tracking supply an acceptable Plan of Correction - (POC) indicating how they will correct those deficiencies. Surveys Awaiting Revisits report AST_AwaitingRevisits.rpt Details facilities/providers with scheduled Reports → Scheduling & Tracking Reports → - (Revisit Due Date) survey revisits that have not yet occurred. Tracking Report → Revisit Due Date Scheduling - Target Month (Target AST_TargetCertMonth.rpt Details a user-selected set of providers, Reports → Scheduling & Tracking Reports → Certification Month Report) providing their last certification dates, their Scheduling Reports → Scheduling Target Month target scheduled dates, how much time has - passed since their last certification, and whether they have been scheduled for their next certification. Termination Summary Report TerminationSummary.rpt Details the number of terminations for the Reports → Schedule & Tracking Reports → selected facilities/providers, broken down by Tracking reports → Termination Summary Report - termination type and facility/provider category.
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Report Name File Name Summary Access New in Release ACTS Reports (Quick Reports - 20 Total) Action Item Report ActionItem.rpt Lists all action items assigned to the user, Tree View → (Right Click) My Action Items → including the current status and date of most Quick Report - recent activity. Allegation Detail Report AllegationDetail.rpt Four print options - Non-EMTALA/Non- Facility Tree View (Right Click) a Facility → Deemed Allegation Detail Report, EMTALA Quick Report → Allegation Detail Report Allegation Detail Report, Deemed Allegation Detail Report and EMTALA/Deemed Allegation Detail Report. Displays basic intake - information and allegation details including category, subcategory, and findings, for selected criteria.
CMS-1541A Form FORM CMS-1541A Displays the Federal CMS-1541A form for the (Right Click) an Intake → Quick Report → CMS - selected intake. 1541A Form CMS-2802 Form FORM CMS-2802 Displays the Federal CMS-2802 form for the (Right Click) an Intake → Quick Report → CMS - selected intake. 2802 Form CMS-562 Form FORM CMS-562 Only available for pre-ASPEN 10.1.7 (Right Click) an Intake → Quick Report → CMS investigation surveys. Displays the CMS-562 562 Form - Medicare/Medicaid/CLIA Complaint Form.
Complaint/Incident Investigation Invest.rpt Displays detailed information about the (Right Click) an Intake → Quick Report → Report provider, intake, complainants, residents, Investigation Report perpetrators, allegations, and investigation. It - also indicates whether deficiencies are linked.
Complaint/Incident Survey Report InvestSummary.rpt Displays provider, survey, complaint/incident, (Right Click) an Intake → Quick Report → allegation, citation, and activity information for Investigation Survey Report all intakes linked to the same investigation as - the selected intake.
Complainant History report Invest.rpt Displays detailed information about all the Facility Tree View → Complainants → (Right intakes and associated investigations, Click) a Complainant → Quick Report → including survey and provider information, Complainant Intake History - that include the selected complainant.
Complainant Intake Summary ClainSum.rpt Lists all the intakes that include the selected Facility Tree View → Complainants → (Right report complainant, and provides basic intake, Click) a Complainant → Quick Report → - (Complainant Intake Listing) provider, and investigation information. Complainant Intake Summary
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Report Name File Name Summary Access New in Release Deemed Provider Report Deemed.rpt Displays selected provider information, and (Right Click) Facility → Quick Report → Deemed lists any intakes and their associated data. Provider Report -
Facility History w/Names (F01) Invest.rpt (F01) Lists intake details for the selected (Right Click) Facility → Quick Report → Facility report facility/provider for the specified time period, History w/Names (F01) including activities, investigations, and - identifies individuals associated with the intake. Facility History, No Names (F02) SummPv.rpt (F02) Lists intake details for the selected (Right Click) Facility → Quick Report → Facility report facility/provider for the specified time period, History, No Names (F02) including activities, investigations, without - names of any individuals associated with the intake. Facility Status report FacilityStatus.rpt Provides facility/provider identification (Right Click) Facility → Quick Report → Facility information and operating status, including, Status as available, administrator information, bed - count, and building information. Facility Summary (F03) report ComplaintTrackingLog.rpt Lists detailed information of intakes for the (Right Click) Facility → Quick Report → Facility selected facility/provider, including intake Summary (F03) numbers and status, allegations, findings, - cited deficiencies (except memo tags 0000, 9999, and 999K), etc. Hotline Call Detail Report Hotline.rpt Displays details about the selected call and Facility Tree View → Hotline → (Expand) a intake (if applicable), including any associated Hotline Category → (Right Click) Selection → - notes. Quick Report Hotline Log report HotlineComplaintLog.rpt Lists all calls received on the Hotline during (Right Click) Hotline → Quick Report the specified time period by all or selected Hotline staff members. Details such as caller - name and call category are provided. Includes any notes.
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Report Name File Name Summary Access New in Release Incident/Complaint Summary SummPV.rpt Displays a summary of information for the (Right Click) Intake → Quick Report → report public about the selected intake; titled Summary - Non-confidential - Complaint Summary or Incident Summary as appropriate. Intake Information report Intake.rpt Displays detailed information about the (Right Click) Intake → Quick Report → Intake selected intake, including provider, Information - complainant, and activity data, as well as any associated intakes. Intake Notes report IntakeNotes.rpt Identifies the intake and provider information, (Right Click) Intake → Quick Report → Intake including any supplementary notes entered Notes - about the complaint/incident. Restraint/Seclusion Facility Death FacResSecl.rpt Displays provider information, and details of (Right Click) Facility → Quick Report → Report any intakes resulting in death associated with Restraint/Seclusion Death Report (F04) - restraint/seclusion.
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Report Name File Name Summary Access New in Release ACTS Reports (Menu Reports - 40 Total) Agency Referral Summary Report AgencySumm.rpt Lists provider name and contact information, Reports → Agency Referral Summary Report as well as any intake details, sorted by - agencies to which the intake was referred.
Allegation Detail Report AllegationDetail.rpt Four print options - Non-EMTALA/Non- Reports → Allegation Detail Reports Deemed Allegation Detail Report, EMTALA Allegation Detail Report, Deemed Allegation Detail Report and EMTALA/Deemed Allegation Detail Report. Displays basic intake - information and allegation details including category, subcategory, and findings, for selected criteria.
Complaint/Incident Allegation ComplaintHistory.rpt Displays allegation information in both Reports → Complaint/Incident Allegation History History report graphical and text form. Allows you to combine or separate provider types, and - provide details of, or summarize the report data. Complaint/Incident Assignment ComplaintLog.rpt Lists assigned intakes and provides Reports → Complaint/Incident Assignment Listing report information including provider name and ID, Listing intake number, assigned and received end - dates, priority, survey exit date and ID, responsible SA and RO, and investigator or scheduler name(s). Complaint/Incident Investigation LogFac.rpt Provides detailed information about Reports → Complaint/Incident Investigation Log Log report investigations, including intake number, priority, survey start and exit dates, findings, - condition-level tags, IJ tags, etc. Non-Deemed Provider - InvestTimeframeIJ.rpt Provides investigation timeliness data for Reports → Federal Only → Federal Investigation Immediate Jeopardy Federal incident intakes with a Priority of A - IJ Timeframe Reports → IJ → Non-Deemed - Incidents Investigation Timeframe involving non-deemed providers. Provider Incidents Report Death-Restraint/Seclusion report RestraintSeclusion.rpt Lists details of any deaths associated with Reports → Death -Restraint/Seclusion (Death Associated with the Use of restraint and/or seclusion, including intake Restraint/Seclusion Report) number, whether death occurred while - restrained, secluded, or both, relevant dates, etc.
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Report Name File Name Summary Access New in Release Deemed Provider Report DeemedAll.rpt Lists intakes for deemed providers with basic Reports → Deemed → Deemed Provider Report Available as provider and intake information, including Regional relevant dates, allegations, findings, tags Report in cited, and other totals. 11.0 Deemed Provider RO Response DeemedInterval.rpt There are three interval options for this report; Reports → Deemed → Deemed Provider RO to Survey Start Interval report Regardless of Interval, RO Response to Response to Survey Start Interval Survey Start, or Exit dates, then select - number of days to use for interval. Lists Deemed intakes that exceed the specified interval. EMTALA Interval Report EmtalaInterval.rpt There are three interval options for this report; Reports → EMTALA → EMTALA Interval Report Regardless of Interval, RO Response to Survey Start, or End dates, then select - number of days for interval. Report lists EMTALA intakes that exceed the specified interval. EMTALA Tracking Report Emtala.rpt Displays detailed information about EMTALA Reports → EMTALA → EMTALA Tracking Report intakes; Including receipt date, provider information, alleged EMTALA violation, date - investigation completed, RO confirmation and response, resolution, etc. Federal Intakes report FederalIntakes.rpt Lists Federal intakes (those linked to a Reports → Federal Only → Federal Intakes Federal survey) for the specified time period. Includes the following fields: Intake Number, Provider Name and Number, Facility ID, - Intake Type, Priority, Event ID, Received Start Date, and Received End Date.
Deemed Provider - Immediate InvestTimeframeIJDeemed.rpt Displays investigation timeliness data for Reports → Federal Only → Federal Investigation Jeopardy Federal Investigation intakes with a Priority of A - IJ involving Timeframe Reports → IJ → Deemed Provider - Timeframe Report deemed providers. Deemed Providers - Non- InvestTimeframeDeemed.rpt Displays investigation timeliness data for non- Reports → Federal Only → Federal Investigation Immediate Jeopardy Federal IJ intakes involving deemed providers, for Timeframe Reports → Deemed Providers - Non- Investigation Timeframe Reports which an investigation was approved, IJ including provider name and number, RO - approval date, Investigation due date, Survey start and exit dates, and days between RO approval and survey start/exit dates.
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Report Name File Name Summary Access New in Release EMTALA Intakes: Federal InvestTimeframeEmtala.rpt Displays investigation timeliness data for Reports → Federal Only → Federal Investigation Investigation Timeframe Report EMTALA intakes, including Intake Number, Timeframe Reports → EMTALA Intakes Provider Name and Number, Received Start - Date and End Date, RO Approval date, Investigation Due date, and Survey Start and Exit dates. Long Term Care: Non IJ InvestTimeframeNonIJ.rpt Provides investigation timeliness information Reports → Federal Only → Federal Investigation High/Medium Federal Investigation for non-IJ High/Medium intakes involving Timeframe Reports → Long Term Care → Non-IJ - Timeframe Reports Nursing Homes. High/ Non-IJ Medium
Hotline Call Summary report HotlineCalls.rpt Lists hotline calls sorted by category for each Reports → Hotline Call Summary month within the specified year, including - monthly and category totals. Incidents Resulting in Deficiencies IncidentsResultingDetail.rpt Lists providers with incidents resulting in Reports → Deficiency Reports → Incidents Detail report deficiencies, including intake number, survey Resulting in Deficiencies → Incidents Resulting start and exit dates, notification date, in Deficiencies Detail - deficiencies cited, and activity completion dates. Incidents Resulting in Deficiencies IncidentsResultingSummary.rpt Lists provider details and totals of incidents Reports → Deficiency Reports → Incidents Summary report resulting in deficiencies for each provider. Resulting in Deficiencies → Incidents Resulting - in Deficiencies Summary Intake Interval Report Interval.rpt Shows the number of days interval between Reports → Interval Report → Intake Interval Intake Accredited Interval Report the Received End Date and the Investigation Report / Intake Accredited Interval Report Due Date, for each intake. It also provides - Survey Start and End Dates, and indicates Priority. Intakes without Scheduled IntakesPendingInvest.rpt Lists data for intakes that require an Reports → Intakes without Scheduled Surveys Surveys investigation survey, but do not have a linked survey (marked as Selected on the Investigation tab), including received end and - investigation due dates, and calendar days remaining and overdue. You can group by None, Priority, Provider Type, or Responsible Team. Investigations Lacking Survey Lack562Upload.rpt Lists investigations with no record of a survey Reports → Federal Only → Investigations Upload report (CSP-SRV) upload being attempted, including Lacking Survey Upload the number of days between the survey start - and exit dates, and the received start and end dates.
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Report Name File Name Summary Access New in Release Non-Deemed Provider - InvestTimeFrameIJ.rpt Displays investigation timeliness data for Reports → Federal Only → Federal Investigation Immediate Jeopardy Federal complaint intakes with a Priority of A - IJ Timeframe Reports → IJ → Non-Deemed - Complaints Investigation involving non-deemed providers. Provider Complaints Timeframe Report Outstanding Activities report OutInvestAct.rpt Lists activities, as defined on the Activities Reports → Outstanding Activities tab, assigned but not yet completed, with associated intake details, including activity - type, assigned and due dates, and responsible staff. QE 562 Log report (Quick Entry QE562Log.rpt Lists Quick Entry (QE) 562 records for a Reports → QE 562 Log 562 Log) specified time frame, including provider information, Survey Exit Date, Recipient of - complaint/incident report, investigating agency, and upload status. Substantiated Complaint by Substantiated.rpt Lists totals of substantiated complaints for a Reports → Substantiated Reports → Provider report specified period of time sorted by facility ID Substantiated Complaint by Provider and provider name, including total number of - intakes and total number of intakes linked to Federal deficiencies. Substantiated Complaint Detail SubstantiatedDetail.rpt Lists details of substantiated complaints for Reports → Substantiated Reports → report the specified period of time, including intake Substantiated Complaint Details number, priority, cited deficiencies (except - memo tags 0000, 9999, and 999K), activities, and other information. Timeliness Report Resolution.rpt Shows those intakes that exceed the user- Reports → Timeliness Reports specified number of days interval for one of eight resolution actions: Triage, Acknowledgement, Investigation, Post-Survey - Contact, RO Action, SOD Issuance, Received to Closure, and Forward to Closure.
Tracking Report - SOD/POC TrackComplaint.rpt Shows SOD/POC (Statement of Reports → Tracking Report SOD-POC Deficiency/Plan of Correction) -related dates - for intakes received within a specified time period. Complaint/Incident Volume By NumCompCumm.rpt Displays a bar graph of the total number of Reports → Volume Reports → Week report intakes received on each day of the week, Complaint/Incident Volume by Week - totaled for each week.
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Report Name File Name Summary Access New in Release Volume by Location Received - NoOfComplaints.rpt Displays the number of intakes received by Reports → Volume Reports → Details Detail report / day of month, sorted respectively by each → Volume By Location Received - Volume by Responsible Team - location and responsible team. → Volume By Responsible Team Detail report Volume by Location Received - SummNumbBar.rpt Displays the number of intakes received by Reports → Volume Reports → Summary Summary report / day of month, sorted respectively by each → Volume By Location Received Volume by Responsible Team - location and responsible team, in bar graph → Volume By Responsible Team - Summary report and text formats, including ranks and percentages. Weekly Summary report NumbCompWeek.rpt Displays the number of intakes received each Reports → Volume Reports → Weekly Summary day throughout the specified week for each - responsible team in table form. Print Batched Letters Allows you to batch print letters, rather than Report → Print Batched Letters printing each letter as it is created. You can list your batched letters only, or define a - custom filter of work units/team, and ASPEN applications. Transactions Report TransactionTracking.rpt Lists upload transactions for a specified Tracking → Transactions → OK → PRINT period. There are numerous selection options - for transactions, including an RO quick list of initial and flagged kits. Intakes Requiring RO IntakesROAuth.rpt Displays only intakes received within a Reports → Federal Only → Intakes Requiring Authorization report specified period of time for which RO RO Authorization 10.2 authorization is required, including Deemed, EMTALA and D/R/S intakes. Facilities with Few (##) or No FacWoIntk.rpt Lists all facilities without any intakes, or with Reports → Volume Reports → Facilities with Intakes report fewer intakes than the specified amount Few or No Intakes 10.2 within the specified timeframe. Investigation Survey Categories InvestCateg.rpt Displays a list of investigations grouped by Reports → Investigation Survey Categories report survey categories for a specified timeframe. 10.2
Investigation Deficiency Types InvestDefType.rpt Lists the type of deficiencies (condition, Reports → Deficiency Reports → Investigation report standard, or none), cited tags, and totals for Deficiency Types 10.2 all specified investigation surveys for each provider. Federal Intake Volume by State ACTSWorkloadEntries.rpt RO Mode Only. Displays daily workload Reports → Volume Reports → Federal Intake (This report is only available for entries for a specified timeframe for each Volume by State 10.2 RO users.) state in the RO. Only Federal intakes are included.
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Report Name File Name Summary Access New in Release AEM Reports (33 Total) Action Items/Next Steps report EnfCaseNext.rpt Details action items, Federal and/or state next Reports → Enforcement Reports → Action steps, and case statuses associated with Items/Next Steps - selected facilities for selected date range.
Case Counts report EnfCaseCounts.rpt Basic report displaying case counts with Reports → Enforcement Reports → Case - various characteristics combinations. Counts Cases in Which No Letter Sent EnfOpenCasesNoLetter.rpt Lists cases in which no letter has been sent Reports → Enforcement Reports → Case report to date, with the default First Date based on Reports → Cases in Which No Letter Sent (Cases For Which No Letter Has facility type. Basic report that allows SA/RO to *Available in RO mode to generate by region Available as Been Sent) focus on a key early processing step. The from Regional Reports. Regional Cycle Start to Today count applies to task not Report in yet completed as of current date: SA first 10.7 letter, initial transfer to RO, or RO first letter.
Cases Not Transferred to RO EnfCaseNotTxToRO.rpt Lists Enforcement cases that should have Reports → Enforcement Reports → Case report been transferred to the RO, but the Initial Reports → Cases Not Transferred to RO Transfer to RO field is not filled in, with the *Available in RO mode to generate by region Available as default First Date based on facility type. All from Regional Reports. Regional Past Noncompliance cases meeting this Report in criteria will appear, however. Verify current 10.7 policy. Reformat the report layout to give Provider and Case specifics. CLIA Enforcement Sanction EnfCLIASanctions.rpt Prints report titled CLIA (Clinical Laboratory Reports → Enforcement Reports → CLIA Report Improvement Amendments) Enforcement Enforcement Sanction Report (Only available when selection set Sanction Log. Prints facility, survey, sanction, - includes CLIA facilities) and registry information based on the filter screen. CLIA Enforcement Registry Report EnfCLIARegistry.rpt Prints report titled CLIA (Clinical Laboratory Reports → Enforcement Reports → CLIA (Only available when selection set Improvement Amendments) Enforcements Enforcement Registry Report includes CLIA facilities) Registry Log. Prints certificate status, - sanction, and registry information based on the filter screen.
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Report Name File Name Summary Access New in Release CMPTS Case Profile report CMPTSProfile.rpt RO mode only - From the CMPTS List Tracking → CMPTS List (Civil Monetary Penalty Tracking window, select the specific facility for which System) you want to create a list, click MODIFY - button, then click PRINT to view case details.
CMPTS List report CMPTSList.rpt RO mode only - From the CMPTS List Available from either path: (Civil Monetary Penalty Tracking window, select PRINT button to create report Reports → Enforcement Reports → CMPs → Reformatted System) that displays all facilities shown on the CMPTS List in 10.7 CMPTS List window, including Provider and Tracking → CMPTS List Case specifics. Denial of Payment report EnfDenialPayment.rpt Prints enforcement cases with Denial of Reports → Enforcement Reports → Remedies Payment remedies/sanctions and the related → Denial of Payment Available as information, according to user-defined *Available in RO mode to generate by region Regional selection criteria. Reformat the report layout from Regional Reports Report in to give Provider and Case specifics. 10.7
Case Log report EnfCaseLog.rpt A list of enforcement cases filtered and Reports → Enforcement Reports → Case Available as (AEM Enforcement Case Log) ordered by the report filter screen selections, Reports → Case Log Regional with the default First Date based on facility *Available in RO mode to generate by region Report in type. from Regional Reports 10.7 Case Profile report EnfProfile.rpt Displays the currently selected Enforcement Reports → Enforcement Reports → Case Profile (Enforcement Case Profile) Case with the following information: Facility, Case Summary, Visit, IJ Situations, Remedies, Civil Money Penalty, Notice, - NATCEP, Hearing, Case Workers, and Case Notes.
Facility Enforcement History report EnfFacHist.rpt Lists a summary of all enforcement cases for Reports → Enforcement Reports → Facility the selected facility within a specified date Enforcement History range, including case dates, type and status, - surveys, remedies and hearing information
Enforcement Transactions Report TransactionTracking_Enf.rpt Lists facility and enforcement case details for Tracking → Transactions → All Transactions for all transactions in the selected time frame. Specified Period (Enforcements) -
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Report Name File Name Summary Access New in Release Federal CMP Analysis report EnfCMPAnalysis.rpt Lists Federal Civil Monetary Penalties Reports → Enforcement Reports → CMPs → (CMPs) for the selected criteria, including Federal CMP Analysis Facility information, CMP Tracking System *Available in RO mode to generate by region (CMPTS) #, Cycle Start Date and relevant from Regional Reports Available as CMP information. There is a comprehensive Regional summary section that can be printed for Report in analysis of CMP trends. Reformat the report 10.7 layout to give Provider and Case specifics.
Federal CMP Due report EnfCMPDue.rpt Details the total Federal Civil Monetary Reports → Enforcement Reports → CMPs → Penalty (CMP) amount due and the related Federal CMP Due Available as CMP information for each enforcement case *Available in RO mode to generate by region Regional with Federal CMP(s) that have not been paid from Regional Reports Report in in full yet. Reformat the report layout to give 10.7 Provider and Case specifics.
Federal/State CMP Tracking EnfCMPTrack.rpt Lists important civil Monetary Penalty (CMP) Reports → Enforcement Reports → report information for the selected criteria, which is Federal/State CMP Tracking useful for the every day tracking and - processing of CMPs at the state level
G+ Enforcement Report - Phase 1 AEM: EnfImmImpReqRem.rpt Lists surveys at S/S G level or above, relating Reports → Enforcement Reports → Remedies and Phase 2 to regulations for Long Term Care Facilities - → G+ Enforcement Report - Phase 1 and Phase Fed-F-16.01. 2 *Available in RO mode to generate by region from Regional Reports 11.3 Reports → Regional Reports → G+ Enforcement Report - Phase 1 and Phase 2 → Generate Report → Select Facility Type → OK → View
IDR Processing Times report IDRProcessingtime.rpt Prints dates related to the Informal Dispute Reports → Enforcement Reports → IDR Resolution (IDR) process for surveys that Processing Times - have IDR, and gives the total number of days.
IDR/IIDR Report IDRDetail.rpt Lists enforcement cases with Informal Reports → Enforcement Reports → Ancillary Available as Dispute Resolution (IDR) and Independent Reports → IDR/IIDR Report Regional Informal Dispute Resolution (IIDR) activity. *Available in RO mode to generate by region Report in from Regional Reports 10.7
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Report Name File Name Summary Access New in Release Immediate Jeopardy Timeline EnfJeopardyTimeline.rpt Displays IJ case timeframes between IJ Reports → Enforcement Reports → Immediate report discovery and compliance. Jeopardy Timeline - *Available in RO mode to generate by region from Regional Reports. Mandatory DPNA Timeline report EnfDCTimeline.rpt Lists cases with Denial Payment for new Reports → Enforcement Reports → Mandatory Admissions (DPNA) remedies and the DPNA Timeline relevant data for denial of payment. Available *Available in RO mode to generate by region - filters include, time period, S/S range, case from Regional Reports.. worker, and only cases within 14 days of 70th day. Medicare Hearing Status report EnfHearingStatus.rpt Lists cases with Medicare hearings and their Reports → Enforcement Reports → Medicare - current status. Hearing Status NATCEP Loss report EnfNATCEPLoss.rpt Lists cases with Nurse Aide Training and Reports → Enforcement Reports → NATCEP Competency Evaluation Program (NATCEP) Loss loss data, primary loss reason, effective date, - last day of loss state waiver effective date and CHOW restart date.
State CMP Due report EnfStCMPDue.rpt Prints the total State Civil Monetary Penalty Reports → Enforcement Reports → State CMP (CMP) amount due and the related CMP Due information for each enforcement case with - state CMP(s) that have not been paid in full yet. Survey IDR/IIDR Detail report IDRDetaiOneSurveyl.rpt Prints IDR/IIDR information related to the Informal Dispute Resolution - IDR for Survey - associated survey. window → Print button Surveys Not in an AEM Case EnfSurveyNotInCase.rpt Lists surveys not currently attached to an Reports → Enforcement Reports → Case report enforcement case. Allows user to configure Reports → Surveys Not in an AEM Case for date range, survey type, and *Available in RO mode to generate by region scope/severity, with the default First Date from Regional Reports. Available as based on facility type. Regional Enlarge / correct the Report Selection screen Report in to show all fields. (Currently, some fields are 10.7 cut off.) Reformatted, for easier viewing.
Termination report EnfTermination.rpt This report prints enforcement cases with Reports → Enforcement Reports → Remedies Available as termination remedies/sanctions and the → Termination Regional related information, according to the selected *Available in RO mode to generate by region Report in report filters. from Regional Reports. 10.7
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Report Name File Name Summary Access New in Release Waiver Report AEMWaivers.rpt Lists enforcement cases with citations citing Reports → Enforcement Reports → Waiver waivers defined by the selected criteria. Report -
Cases Not Uploaded report (AEM AEM:EnfCasesNotUploaded.rpt Lists cases never successfully uploaded to Reports → Enforcement Reports → Cases Not Enforcement Cases Not National, have their first upload pending for Uploaded Uploaded) tonight, and that have been previously uploaded but had a "Delete from National" with no subsequent successful uploads. Also 10.3 includes the highest S/S for the first visit and the whole case cycle. The number of days uses the difference between cycle start and end dates.
CMP Analytic Tool Report AEM:EnfCMPAnalyticTool.rpt Lists current and potential CMP cases, with Reports → Enforcement Reports → CMP the information used by the CMP Calculation Analytic Tool Report Tool to calculate CMP amounts. Allows users to configure by case status, SA/RO primary 10.5 worker, facility type, case type, and date range, and helps ROs track how CMPs are calculated.
Repeat Deficiency Cases Report AEM:EnfRepDefs.rpt Lists cases with repeat deficiencies. Includes Reports → Enforcement Reports → Survey CCN, provider name, enforcement case ID, Citations → Repeat Deficiencies Cases Report Available as current and prior survey dates, the repeated *Available in RO mode to generate by region Regional deficiency with related S/S, and whether the from Regional Reports Report in repeated deficiency is worse, the same, or 10.7 improved.
Special Focus Facilities report SpecialFocusFacility.rpt Lists facilities based on the Special Focus Reports → Enforcement Reports → Survey periods entered in the Facility Properties Citations → Special Focus Faclities Available as window Other tab. Includes the facility name, *Available in RO mode to generate by region Regional ID, CCN, and address, as well as the special from Regional Reports Report in focus period date range. 10.7 CMS 2567 Sent to Facilities report CMS2567SentToFac.rpt Lists surveys by facility with the survey event Reports → Enforcement Reports → Survey ID, exit date, and type, with the number of Citations →CMS 2567 Sent to Faclities days since the exit date the CMS 2567 form *Available in RO mode to generate by region Available as was sent to the facility. Surveys with no 2567 from Regional Reports Regional sent to facilities can also be listed. Includes Report in facility name, address, ID, CCN, state key, 10.7 and license number.
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Report Name File Name Summary Access New in Release AEM Reports - Draft Reports (16 Total) Checks Received report EnfChecksReceived.rpt Lists facility, enforcement case, and cycle Reports → Enforcement Reports → Draft information, as well as check amount and Reports → Checks Received - date received. Cases Closed report EnfClosedCases.rpt List of closed cases, with facility and date Reports → Enforcement Reports → Draft - (Closed Cases Report) information. Reports → Cases Closed CMPs Paid report EnfCMPPaid.rpt Lists Civil Monetary Penalty (CMP) amounts Reports → Enforcement Reports → Draft and dates collected according to user- Reports → CMPs Paid - specified selection criteria. Compliance Issues (Detail) report EnfComplianceIssues.rpt A list of cases showing the timeline of the Reports → Enforcement Reports → Draft state's 1st visit, sending to the RO, total Reports → Compliance Issues - number of visits and the interval between cycle start and compliance dates. NATCEP Current report FacilityList.rpt Prints Facility Quick List, including facility Reports → Enforcement Reports → Draft - (Facility Quick List) address and contact information. Reports → NATCEP Current All Pending Remedies report EnfAllPendingRemedy.rpt Lists counts of all remedies with a current Reports → Enforcement Reports → Draft (Pending Remedy Counts - Detail) Pending status. Reports → All Pending Remedies -
Remedy Counts Detail report EnfPendingRemedy.rpt Lists details of select remedies that have a Reports → Enforcement Reports → Draft (Pending Remedy Counts – Detail) current Pending status. Reports → Remedy Counts Detail -
(Pending) Remedy Counts EnfPendingRemedySummary.rpt Summary counts and details of pending Reports → Enforcement Reports → Draft - Summary report remedies for the selected report criteria. Reports → Remedy Counts Summary OMR: Pend. Terminations report EnfPendingTermination.rpt Lists cases that potentially are going to be Reports → Enforcement Reports → Draft (Pending Terminations Report) terminated (Remedy 11B - Mandatory Reports → OMR: Pend. Terminations Termination), and dates for the terminations. -
OMR: RO Early Proc. Times EnfEarlyProcess.rpt Displays Office of Medical Review (OMR) Reports → Enforcement Reports → Draft report facility and enforcement case information, Reports → OMR: RO Early Proc. Times (RO Early Processing Times – and RO processing times by provider, - Detail Report) according to user-defined selection criteria.
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Report Name File Name Summary Access New in Release RO Multi Processing Times EnfMultiProcess.rpt Lists cases on which the RO is working, with Reports → Enforcement Reports → Draft (Detail) report timeframes from sending notices, and Reports → RO Multi Process Times - performing revisits to closure. OMR: RO-SA Early Proc. Times EnfStateEarlyProcess.rpt Lists Office of Medical Review (OMR) Reports → Enforcement Reports → Draft report timeframes for SA and RO processing of Reports → OMR: RO-SA Early Proc. Times - (RO State Early Processing Times enforcement cases - Detail Report) SA Perf. Eval: 6 Month EnfSAPerfEval.rpt Lists facility and initial visit information for Reports → Enforcement Reports → Draft Compliance report cases without compliance by the 90th and Reports → SA Perf: 6 Month Compliance 160th day of the case, as well as the 6 month - termination date, for SA Performance analysis of compliance processing. SA Perf: IJ Process report EnfIJTermProcess.rpt Lists cases with Immediate Jeopardy (IJ) Reports → Enforcement Reports → Draft (SA Perf Eval: IJ Term. Process) situations, including initial and IJ visits, for Reports → SA Perf: IJ Process - State Agency Performance analysis of IJ processing State Visit Processing Times EnfStateVisit.rpt Displays facility enforcement cases and the Reports → Enforcement Reports → Draft (Detail) report intervals between visits for the case, and the Reports → State Visit Processing Times - intervals between visits for the case and the RO Received date. OMR: Term. Facilities report EnfTerminatedFacilities.rpt Lists information for all the terminated Reports → Enforcement Reports → Draft (Terminated Facilities Report) facilities based on the report selection criteria, Reports → OMR: Term. Facilities - including process beginning, end and visit dates.
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Report Name File Name Summary Access New in Release CLIA (7 Total) CLIA 116 Application List report CLIA116AppList.rpt Provides CLIA 116 application information, Reports → CLIA Reports → CLIA 116 Application including CLIA number, lab information, SA List received and 116 complete dates, added by - name, paid in full and upload status, and type of application for selected date range.
CLIA Laboratory Profile Report CLIALabSrchList.rpt Displays a list of all CLIA laboratories that Reports → CLIA Reports → CLIA Laboratory match the specified report selection criteria, Profile Report - including facility, director, and certification information. CLIA Nightly Facility Update report CLIANightlyFacilityUpdate.rpt Shows facility changes made in CLIA applied Reports → CLIA Reports → CLIA Nightly Facility to provider records in ASPEN by the nightly Update - extract process. No. of Sites Mismatch report CLIANoSitesMismatch.rpt Displays a list of all CLIA laboratories where Reports → CLIA Reports → No. of Sites (Number of Sites Mismatch the number of sites entered does not match Mismatch - Report) the value entered in the Number of Sites field.
QC Exclusion report CLIAQCExclusion.rpt Lists all Quality Control (QC) exclusion tags Reports → CLIA Reports → QC Exclusion assigned during a specified date range. -
Discrepancy report (Validation CLIADiscrepancy.rpt Lists CLIA labs with discrepancies in specialty Reports → CLIA Reports → Discrepancy Survey Discrepancy Report) data found during a validation survey. -
Workload Monitoring report (CLIA CLIAWorkloadMonitoring.rpt Provides total counts and survey information Reports → CLIA Reports → Workload Workload Monitoring) for survey categories for a specified date Monitoring - range.
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Report Name File Name Summary Access New in Release CMS Forms (31 Total) CMS-29 Form29.rpt Provides facility name, address, type, phone, Certification Sheet → App/CDE (CMS-29/30E) email, and active date information for a → PRINT - selected administrator. CMS-30E Form30E.rpt Rural Health Clinic Survey Report - Crucial Certification Sheet → App/CDE (CMS-29/30E) - Data Extract → PRINT CMS-359 Corf359.rpt Comprehensive Outpatient Rehabilitation Certification Sheet → Application (CMS-359) → Facility Report for Certification to Participate PRINT - in the Medicare Program CMS-377 Form377.rpt Ambulatory Surgical Center Request for Certification Sheet → App/CDE (CMS-377/378E) - Certification in the Medicare Program → PRINT CMS-378E Form378ee.rpt Ambulatory Surgical Center Survey Report Certification Sheet → App/CDE (CMS-377/378E) - Crucial Data Extract → PRINT CMS-417 Hospice_417.rpt Hospice Request for Certification in the Certification Sheet → Application (CMS-417) → - Medicare Program PRINT CMS-562 Form cms562.rpt Medicare/Medicaid/CLIA Complaint Form Intake Sheet → Deemed tab → PRINT CMS 562 - Form CMS-643 Hospice643.rpt Hospice Survey and Deficiencies Report Certification Sheet → Application (CMS-643) → - PRINT CMS-670 FORM CMS-670 Survey Team Composition and Workload Survey Node → Print Form → CMS 670 - Report State Workload Report oSt670.rpt Presents all of the state workload information Survey Node → Print Form entered on the CMS-670 form for a selected survey, showing specifically the total hours for each surveyor on the survey team and the - total office hours that were entered for that survey. 670 Summary (670s) o670SummaryWithoutGroupBy Lists surveys during the specified period of Reports → Survey History Reports → 670 Survey.rpt time in alphabetical order by facility for Summary (670S) selected regulation sets. Survey team size, - exit date, and personnel hours for each survey are included in the report. 670 Summary (670S) o670Summary.rpt Lists surveys during the specified period of Reports → Survey History Reports → 670 time by survey type for selected regulation Summary (670S) – With Group By Survey Type sets. Survey team size, exit date, and option selected - personnel hours for each survey are included in the report.
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Report Name File Name Summary Access New in Release CMS-671 LTC671Application.rpt Long Term Care Facility Application for Certification Sheet → Application (CMS 671) → - Medicare and Medicaid PRINT CMS-672 Census672.rpt Resident Census and Conditions of Certification Sheet → Census (CMS-672) → - Residents PRINT CMS-1539 o1539.rpt Medicare/Medicaid Certification and Certification Sheet → Transmittal (CMS-1539) - Transmittal → PRINT CMS-1541A FORM CMS-1541A Request for Survey of Section 489.20 and Intake Sheet → Deemed tab → PRINT CMS Section 489.24 Essentials of Provider 1541A Form - Agreements CMS-1541B FORM CMS-1541B Responsibilities of Medicare Participating Intake Sheet → Deemed tab → PRINT CMS Hospitals in Emergency Cases Investigation 1541B Form - Report CMS-1557 ohfca1557.rpt Survey Report Form (CLIA) Certification Sheet → Survey (CMS-1557) → - PRINT CMS-1572A ohcfa1572.rpt Home Health Agencies Survey and Certification Sheet → Application (CMS-1572A) - Deficiencies Report → PRINT CMS-1856 Form1856.rpt Request for Certification in the Medicare Certification Sheet → Application (CMS-1856) and/or Medicaid Program to Provide → PRINT - Outpatient Physical Therapy and/or Speech Pathology Services CMS-1880 Surv1880xray.rpt Request for Certification as Supplier of Certification Sheet → Application (CMS-1880) Portable X-Ray Services under the → PRINT - Medicare/Medicaid Program CMS-1893E Form1893E.rpt Outpatient Physical Therapy Survey - Speech Obsolete (v8.7 per DTR-1755) Pathology Report Crucial Data Extract -
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Report Name File Name Summary Access New in Release CMS-2567 o2567.rpt Statement of Deficiencies and Plan of Survey Node → Print Form → CMS 2567 - Correction CMS-2567B o2567B.rpt Post-Certification Revisit Report Survey Node → Print Form → CMS 2567B - CMS-2567 o2567Large.rpt Lists all of the tags cited for a particular Survey Node → Print Form survey as well as all of the citation text that - was entered for each tag. CMS-2567 oSt2567.rpt Lists all of the state tags cited for a particular Survey Node → Print Form survey as well as all of the citation text that - was entered for each tag. CMS-2567 oSt2567Large.rpt Lists all of the state tags cited for a particular Survey Node → Print Form survey as well as all of the citation text that - was entered for each tag. CMS-2786 Form Form CMS-2786 Fire Safety Survey Report Crucial Data Certification Sheet → LSC 2786 tab → PRINT (Fire Safety Survey Report) Extract 2786 - CMS-2802 hcfa2802.rpt Request for Validation of Accreditation Intake Sheet → Deemed tab → PRINT select Survey for Hospital. Other versions of report form are available for Hospice (B), HHA ©, ASC - (D), CAH (E), and Psychiatric Hospital (F).
CMS-3070G surv3070.rpt Intermediate Care Facility (ICF) for Certification Sheet → Application (CMS-3070G) Individuals with Intellectual Disabilities (IID) → PRINT - Survey Report CMS-3427 Form3427.rpt End Stage Renal Disease Certification Sheet → Application (CMS-3427) Application/Notification and Certification → PRINT - Request
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Report Name File Name Summary Access New in Release ePOC Reports (15 Total) Deficiency Free Surveys report epocSurveysDeficiencyFree.rpt Provides a list of surveys with no cited Reports → ePOC Management Reports → deficiencies for selected date range, including Deficiency Free Surveys - survey and facility information. Surveys Changed Since Posting ePOCSurvey.rpt Lists surveys that have been edited since Reports → ePOC Management Reports →Re- report original posting. post Required Reports → Surveys Changed - Since Posting Deficiencies Not Posted report UnpostedDeficiencies.rpt Lists surveys with deficiencies, excluding tags Reports → ePOC Management Reports → Re- removed/changed due to a post Required Reports → Deficiencies Not - settlement/hearing, that have not been Posted posted to ePOC. Stopped Surveys report epocStoppedSurvey.rpt Lists surveys that have been stopped. Reports → ePOC Management Reports → Includes facility in formation, event ID Stopped Surveys - information, and survey and POC dates for selected date range. Unlocked Surveys report ePOCSurvey.rpt Lists surveys that are unlocked, including Reports → ePOC Management Reports → facility and survey ID information, with SOD Unlocked Surveys - sent and POC due dates for the selected date range. Facilities Having ePOC Users FacPOCUsers.rpt Lists ePOC enabled facilities with assigned Reports → ePOC Management Reports → Filterable by report web users. ePOC Web Users Reports → Facilities Having CCN ePOC Users Facilities Pending SA/RO POC FacilitiesPendingSAROActivity.r Shows all facilities with newly submitted or re- Reports → ePOC Management Reports → Review report pt submitted POCs, excluding tags Facilities Pending SA/RO POC Review removed/changed due to a - settlement/hearing, which are awaiting SA review. Facilities Without ePOC Users FacPOCUsers.rpt Lists ePOC enabled facilities without Reports → ePOC Management Reports → Filterable by report assigned web users. ePOC Web Users Reports → Facilities Without CCN ePOC Users Plan of Correction Audit Trail PlanOfCorrectionAuditTrail.rpt Shows all POC activities (submissions, re- Reports → ePOC Management Reports → Plan report submissions, rejections, approvals, etc.) for a of Correction Audit Trail - specific facility or group of facilities.
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Report Name File Name Summary Access New in Release Rejected Tags Requiring Facility RejectedTagsRequiringFollowup Shows all rejected deficiencies,excluding tags Reports → ePOC Management Reports → Follow-up report POC.rpt removed/changed due to a Rejected Tags Requiring Facility Followup settlement/hearing, for which facilities have - not re-submitted a POC within specified time frames
SOD Acknowledgement Missing SODAcknowledgementMissing.r Shows all deficiency-free surveys for which Reports → ePOC Management Reports → SOD report pt the facility has not acknowledged review of Acknowledgement Missing - the SOD, where acknowledgement is required. Survey POC Information report SurveyPocInformation.rpt Displays detailed POC data, excluding tags Reports → ePOC Management Reports → removed/changed due to a settlement or Survey POC Information hearing, as well as the following survey information: Event ID, SOD Sent Date, POC Due Date, POC Received Date (date of the first POC submission for any tag on the survey), POC Last Rejected Date (date of the - last POC rejection for any tag of the survey), POC Final Approval (last approval date for all non-0000 tags on the survey), and Last Submitted (date of the last POC submission for any tag on the survey).
Tardy POC Submission From NoPOCEverReceived.rpt Shows all deficiencies, excluding tags Reports → ePOC Management Reports → Tardy Facility report removed/changed due to a POC Submission From Facility - settlement/hearing, for which facilities have Tardy SOD Issuance report TardySODIssuance.rpt Showsnot submitted all surveys a POC (Excluding within specified stopped time Reports → ePOC Management Reports → Tardy surveys) not signed off within 10 days of SOD Issuance - survey exit date. ePOC Reports can exclude FacPOCUsers.rpt Reports → ePOC Management Reports → Create list of reports that excludes facilities facilities without CCN ePOC Web Users Reports → Failities Without 11.00 without a CCN ePOC Users
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