The incumbent is responsible for conducting in?depth surveys and investigations of licensed healthcare facilities to determine compliance with State licensing and Federal certification requirements. The position evaluates the quality of patient care, assesses compliance with applicable laws and regulations, and prepares comprehensive documentation to support enforcement actions when necessary. The incumbent also represents the Department in administrative and legal proceedings, provides technical guidance to facility administrators, and participates in activities that support statewide consistency in regulatory oversight.

• Travel to healthcare facilities to conduct comprehensive compliance surveys, individually or as part of a team.

• Conduct and document interviews with residents, staff, and other relevant personnel to gather information on facility operations and patient care.

• Request, review, and evaluate medical records while ensuring full protection of patient confidentiality.

• Determine facility compliance with state and federal laws, regulations, and certification requirements using survey findings and direct observations.

• Prepare clear, comprehensive narrative reports outlining findings, conclusions, and recommendations.

• Draft written statements of deficiencies when non?compliance is identified.

• Conduct complaint investigations related to patient care and healthcare delivery, documenting all evidence sufficient for legal action.

• Prepare and deliver written or verbal testimony during conferences, hearings, and other legal proceedings to support civil monetary penalties or enforcement actions.

• Serve as an expert witness regarding State and Federal regulatory requirements governing patient care and healthcare delivery.

• Participate in meetings, workgroups, and local program activities to promote consistent statewide application of regulatory standards.

• Attend trainings to maintain current knowledge of trends, issues, and best practices in healthcare delivery systems.

• Provide consultation to healthcare facility administrators related to licensing requirements, inspections, construction standards, and operational compliance.

• Perform other assigned duties including data collection for special studies and preparation of licensing or complaint?related documentation.