As a former surveyor (for about five minutes back in 2014), I was told I was "too friendly" with the staff; I know exactly how it feels to be on the receiving end of a survey, and I wanted to put them at their ease as much as possible. That's not OK, it really is an adversarial encounter and nobody is happy to be there. The job really *is* about finding evidence of poor care, and not in just nursing, but dietary, environmental services, even the laundry facilities. And yes, we knew exactly which charts we were going to pull before we entered, and they were always the residents with wounds, behaviors (gotta get rid of those pesky antipsychotics, you know), diabetes, weight loss etc. The deck is stacked against the NH, and deficiency-free surveys are unusual.
I'm sorry the process is so stressful, for all concerned. I'm actually glad I'm no longer a surveyor because I hated putting the screws to facilities that were doing their best to care for their residents. I did see one IJ tag that was richly deserved---the facility didn't have call lights on one whole hall because, according to the administrator, "the residents are too confused to use them"! So the annual inspections do have a purpose, but I totally get the stress involved. I've sat in on many an exit in my years as a nurse manager and DNS.