Run HRSA Operational Site Visit Preparation Checklist — Free

Visit Logistics and Document Control

HRSA OSV date, location, and reviewer contact information documented

OSV agenda, protocol, and requested document list reviewed by leadership critical (required)

Yes No N/A

Central document repository established with version control critical (required)

Yes No N/A

Point of contact assigned for HRSA reviewers and document retrieval critical (required)

Yes No N/A

Governance and Corporate Compliance

Current bylaws, articles of incorporation, and board roster available critical (required)

Yes No N/A

Board meeting minutes show required oversight of operations and quality critical (required)

Yes No N/A

Conflict-of-interest disclosures completed for board members and key staff critical (required)

Yes No N/A

Sliding fee schedule, discount policy, and related approvals available

Yes No N/A

Policies for compliance reporting, corrective action, and issue escalation current

Yes No N/A

Clinical Operations and Access to Care

Credentialing and privileging files current for all licensed clinicians critical (required)

Yes No N/A

Scope of practice and supervision requirements documented and followed critical (required)

Yes No N/A

Appointment access, triage, and after-hours coverage policies available critical (required)

Yes No N/A

Referral tracking and follow-up process documented with recent examples

Yes No N/A

Patient complaint and grievance logs current and retrievable

Yes No N/A

Quality Improvement and Performance Management

Quality Improvement plan current and approved critical (required)

Yes No N/A

Recent QI committee minutes show data review and action items critical (required)

Yes No N/A

Clinical quality measures tracked with current performance data critical (required)

Yes No N/A

Corrective actions documented for measures below target

Yes No N/A

Patient satisfaction or access feedback reviewed and trended

Yes No N/A

Human Resources and Staffing Files

Personnel files contain licenses, certifications, and job descriptions critical (required)

Yes No N/A

Annual training records completed for required compliance topics critical (required)

Yes No N/A

Background checks, references, and onboarding documentation retained as required

Yes No N/A

Staffing schedule reflects adequate coverage for services offered

Yes No N/A

Emergency contact list and leadership coverage plan current

Yes No N/A

Facilities, Safety, and Emergency Preparedness

Emergency preparedness plan current and accessible critical (required)

Yes No N/A

Fire drill, evacuation, and incident logs available for review critical (required)

Yes No N/A

Fire extinguishers, exits, and egress routes unobstructed and clearly marked critical (required)

Yes No N/A

Hazardous materials, eyewash, and SDS access reviewed

Yes No N/A

Any open facility deficiencies or corrective actions documented

Yes No N/A

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Run: HRSA Operational Site Visit Preparation Checklist

Visit Logistics and Document Control

Governance and Corporate Compliance

Clinical Operations and Access to Care

Quality Improvement and Performance Management

Human Resources and Staffing Files

Facilities, Safety, and Emergency Preparedness

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