Checks consist of internal and external audits of financial measures, as well as clinical indicators of continuous readiness for all licensure and accreditation surveys. In 2010, TL began to include all employees in observations for resident safety and environment of care at SNFs. This provides more robust findings and educates employees on the performance desired as well as engaging them in and empowering them to be accountable for the results. Findings are aggregated and reported on the systemwide APEX scorecard.