Patient Origin Data Survey

The Department of Health’s Division of Certificate of Public Need (DCOPN) will soon email to each nursing facility in Virginia a form requesting five items of basic information about residents (date of birth, gender, date of admission, source of admission, and zip code of prior residence).  DCOPN intends to gather the information to assess the need for nursing facility beds in each of Virginia's planning districts.  DCOPN will ask providers to report these data items for each resident in the facility on one specific date within a date range on an Excel spreadsheet.

Click here to see DCOPN's drafts of the letter of explanation for the request, instructions for completing the form, and the spreadsheet form to be completed.

Once this email request from DCOPN is received, please follow the instructions closely and return the patient origin data to DCOPN in a timely manner.  The information is very important for an accurate assessment of nursing facility beds need across the state.