Survey Process in Your State

26.	Do you have concerns about the quality of the survey process in your state?
	(Click one)
	1.		Yes
	2.		No (Click here to go to question 31.)

27.	Have you raised these concerns with anyone?
	(Click one)
	1.		Yes
	2.		No (Click here to go to question 29.)

28.	Please indicate with whom you have raised your concerns about the survey process in your state.
	Check one answer in each row

		Yes	No
	a. Managers at your state survey agency (or state survey agency district office)
	b. CMS regional office staff
	c. CMS headquarters or central office staff
	d. Other

	If you responded to question 28, please go to question 30.

29.	If you have not raised your concerns, please indicate your reasons.
	Check one answer in each row

		Yes	No
	a. Fear of retaliation
	b. Don't know whom to tell
	c. Don't feel that it would make a difference
	d. Other

30.	If you wanted to contact CMS to express concerns about the survey process in your state, would you know how to do so?
	(Click one)
	1.		Yes
	2.		No
	3.		Not sure/No opinion

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Full Report: GAO-10-70

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