This report, “A Guide to Nursing Home Oversight & Enforcement,” identifies key requirements for state agencies in the federal regulatory requirements and the State Operations Manual which lays out detailed expectations and guidance for state surveyors. Download the full report or access individual sections in the toggle boxes on the right.
Resources for Surveyors
The Centers for Medicare & Medicaid Services (CMS) released the following guidance for nursing home surveyors. Appendix PP provides interpretive guidelines for long-term care facilities. Critical Element Pathways* are used for investigating potential care areas of concern.
Appendix PP – Guidance for Surveyors
Appendix Q
Appendix Z
Chapter 7 – State Operations Manual
Immediate Jeopardy Template
Long Term Care Survey Process (LTCSP) Procedure Guide
Psychosocial Outcome Severity Guide
Scope and Severity Grid
Abuse*
Accidents*
Activities*
Activities of Daily Living*
Arbitration*
Behavioral-Emotional*
Beneficiary Notice*
Bladder and Bowel Incontinence*
Comm-Sensory*
Death*
Dementia Care*
Dental*
Dialysis*
Dining*
Discharge*
Environment*
Extended Survey*
General*
Hospice and End of Life*
Hospitalization*
Hydration*
Infection Prevention Control and Immunization*
Kitchen*
Medication Administration*
Medication Storage*
Neglect*
Nutrition*
Pain Management*
PASARR*
Personal Funds*
Physical Restraints*
Positioning, Mobility, ROM*
Pressure Ulcer*
QAPI and QAA*
Rehab and Restorative*
Resident Assessment*
Resident Council*
Respiratory Care*
Sufficient and Competent Staff*
Tube Feeding*
Unnecessary Medications*
Urinary Catheter or UTI*