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.

States are required by law to carry out numerous responsibilities to ensure that residents are safe and that their care needs are met every day of the year. This guide aims to highlight and synthesize those responsibilities.

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What you’ll learn:

  • Foundation for state agency activities
  • Functions and responsibilities of state agencies
  • Authority of the CMS Locations (aka Regional Offices)

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What you’ll learn:

  • Survey team size and composition; survey frequency
  • Conflicts of interest for surveyors
  • Complaint/incident process and how state agencies manage complaints
  • Types of surveys and how they are conducted
  • Actions taken when a facility is not in substantial compliance

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What you’ll learn:

  • The definition of inadequate survey performance
  • Performance standards required in the §1864 Agreement (contract between CMS and state governments for a state agency to carry out quality assurance and oversight)
  • CMS’s evaluation process

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What you’ll learn:

  • Types of remedies CMS or the state may impose on facilities
  • Actions taken in immediate jeopardy situations
  • Requirements for reporting abuse

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What you’ll learn:

  • Basis for CMPs
  • How CMPs are determined
  • When CMPs and due and payable
  • How CMPs are collected and used

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What you’ll learn:

  • What and when information must be made available to the public
  • Information that must be provided to long-term care ombudsmen
  • Information that must be furnished by facilities with substandard quality of care

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F-Tag list, Scope & Severity grid, CMS summary of certification, and more.

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