Department of Health
John J. Dreyzehner, MD, MPH, Commissioner
Health Care Facilities
Health Care Facilities: Documents and Publications
- 2002 Unusual Event Summary Report
- 2003 Nursing Home Report
- 2004 Nursing Home Report
- 2005 Nursing Home Report
- 2006 Nursing Home Report
- 2007 Nursing Home Report
- Applications
- Advance Directives Forms
- Architectural & Engineering Guidelines for Submission, Approval & Inspection of Occupancies Licensed
- Assisted Care Living Facility Plans Review and Submittal Form (PH-4096)
- Critical Access Hospitals
- CMS National Provider Indentifiers (NPI) Notice
- Complaint/Investigation Intake Report
- Designated Trauma Centers
- Educational Training for Nursing Homes (ppt)
- Facility Document (Sample)
- Hospice Waiver Request Instructions
- Interpretative Guidelines for Reporting Unusual Incidents Manual - January 2005
- Quality Enabling Program Participants
- Patient Record of Influenza Vaccination Consent/Declination (pdf)
- Patient Record of Influenza Vaccination Consent/Declination (doc)
- Pediatric Emergency Care Levels
- Plans Review Submittal Form
- Procedures for Appear Before the Board for a Waiver Request
- Questions and Answers from Nursing Homes Educational Seminars (February 2008)
- Recommended Best Practices - 7 Components of Abuse Prevention
- Recommended Best Practices - Medication Errors
- Recommended Best Practices - Wrong Site Surgery
- Self-Evaluation Survey Form (PH-2714) for Nursing Homes
- Self-Evaluation Survey Form for Hospitals & Other Facilities
- Self-Evaluation Guide for Section 504
- Sprinkler Status Reports: Nursing Homes
- Sprinkler Status Reports: Assisted Care Living Facilities
- Sprinkler Status Reports: Homes for the Aged
- Toll-Free Hotline Numbers Example Sign
- Training for Nursing Home Staff and Administrators
- Unusual Events Reporting Form Letter
- Unusual Event Report (Sample Form)
- Unusual Incident Report Form (PH-3688)
- Unusual Incident Medication Error Report Form (PH-3689)
- Unusual Incident Investigative Analysis Form (PH-3687)
Governor Bill Haslam
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