Long-Term Care Survey Alert

Survey Trends:

AHCA CITES SPECIFIC REASONS FOR SURVEY INCONSISTENCIES

Published on Tue Apr 01, 2003

The American Health Care Association has identified for the Centers for Medicare & Medicaid Services what the group believes to be some specific causes of inconsistencies in survey findings nationwide:

Vagueness of CMS' definitions and guidance. For example, the definitions of "deficiency, harm, scope, and severity" and related survey guidance are subject to varied interpretations.

Political pressure, including that from (or placedon)the governor, department of health and/ or survey agency (SA) director.

Inconsistency or failure in communication from CMS central office to the regional offices or ROs.This problem encourages RO leaders to make their own decisions about CMS policy interpretations and send directives to their respective SAs that may differ from CMS Central Office and other ROs.

Variations in SAs' interpretation of CMS policy directives, guidance and expectations.

Extent or quality of the SA leaders' oversight of survey teams' work and findings. This includes use of quality assurance or quality management processes to hold surveyors accountable and ensure that deficiency citations are valid and correct.

Variations in SAs' emphasis.For example, one SA may emphasize pressure ulcer care and compliance while another emphasizes patient elopements from facilities as a safety issue.

Composition of survey teams.If a dietitian or pharmacist is a regular member of the team in a state, higher deficiency rates in their respective areas have been noted compared to states in which these professionals are used only as consultants.

Previous experience of survey team members. Those with long-term care experience generally have a better understanding of the patients, care and expectations in nursing facilities.

Federal regulations that allow deficiencies to stand even if surveyors do not follow CMS procedures.

Long-Term Care Survey Alert

Survey Management:
PREEMPT TOP F TAGS WITH PATIENT SAFETY ROUNDS
If a surveyor asked you how safe residents are from accidents and clinical shortfalls, what [...]

Survey Management:
GUARD AGAINST THESE POTENTIAL SURVEY SCENARIOS UNDER HIPAA
Here's one of those million-dollar questions: Can surveyors cite your facility for HIPAA violations under [...]

Restorative Care:
THIS FORM OF ADL OVERCODING WILL DRIVE UP YOUR QI/QM SCORES
Some facilities unintentionally overcode activities of daily living on the MDS when nursing staff does [...]

Resident Privacy:
HOW TO NEGOTIATE CONFLICTS BETWEEN OBRA AND HIPAA
On April 14, HIPAA officially joined OBRA in the long-term care arena and facilities are [...]

Survey Trends:
OIG REPORT MAY SPELL SURVEY RELIEF FOR FACILITIES
It's official: The survey system shows an unacceptable " wide variation" among states in the proportion [...]

Survey Trends:
AHCA CITES SPECIFIC REASONS FOR SURVEY INCONSISTENCIES
The American Health Care Association has identified for the Centers for Medicare & Medicaid Services [...]

READER QUESTION:
Survey civil monetary penalties
Q: How long should a per diem civil monetary penalty be allowed to run in [...]

Fire Safety:
TAKE FIRE SAFETY PRECAUTIONS WITH ALCOHOL HAND RUBS
Those alcohol hand gels are a great infection control tool, but they might also prove [...]

SURVEY & CLINICAL NEWS
CMS posts draft version of MDS 3.0. Check out the draft version of the MDS [...]

Quality of Care:
PERFORM THESE SAFETY CHECKS FROM YOUR DESK
You can actually perform some vital patient safety checks without ever leaving your computer or [...]

HIPAA Disclosure Worksheet

View All