Nursing Home Federal Requirements: Guidelines to Surveyors and Survey Protocols, 7th Edition

by James E. Allen PhD, MSPH, NHA, IP

Overview

"[The book] lists all the federal requirements that are evaluated by state surveyors during the annual survey visit to nursing homes and for complaint visits. The exhibit section contains forms used by surveyors to gather data during the survey visit. Visually, the format makes the regulations easy to read. If nursing home staff used the book to prepare for a survey, they would be well prepared."

Marcia Flesner, PhD, RN, MHCA
University of Missouri-Columbia
From Doody's Review

The Federal government, together with more than 50 advocacy groups, has spent the past 40 years writing and refining the rules and guidelines in this manual.

This book presents the latest federal guidelines and protocols used by federal surveyors in certifying facilities for participation in Medicare and Medicaid funding. It is an essential resource for long-term care facilities to have on hand to be ready for a survey at any time. It provides information straight from CMS's Internet-Only Manual-in print and at your fingertips for easy access.

Divided into four accessible and user-friendly parts, this manual includes:

Federal requirements and interpretive guidelines

Rules for conducting the survey

Summary of the requirements for long-term care facilities and surveyors

CMS forms commonly used by surveyors

This newly updated and revised edition spans every aspect and service of a nursing home and represents the latest requirements to ensure that outstanding quality assurance and risk management programs are in place.

New to This Edition:

• Section on how to use manual
• Summarization of federal requirements
• Updated definitions of Medicare and Medicaid
• Compliance requirements with Title VI of the Civil Rights Act of 1964
• SNF/Hospice requirements when SNF serves hospice patients
• SNF-based home health agencies
• Life safety code requirements
• Changes in SNF provider status
• Surveyor qualifications standards
• Management of complaints and incidents
• New medical director guidelines

Product Details

ISBN-13:	9780826107923
Publisher:	Springer Publishing Company
Publication date:	11/24/2010
Sold by:	Barnes & Noble
Format:	eBook
Pages:	616
File size:	7 MB

About the Author

James E. Allen, PhD, MSPH, NHA, IP, is President of Long Term Care Education.com, a national resource website for information on the long-term care field. He is also President of ANCCceus-Nursing Education.com, a nationally approved CEUS for nurses, and Professor, Health Policy and Administration Emeritus, School of Public Health, University of North Carolina at Chapel Hill.

Table of Contents

"Part One

Federal Requirements and Guidelines to Surveyors

ß483.1 Basis and Scope

ß483.5 Definitions

ß483.10 Resident rights

(a) Exercise of rights
(b) Notice of rights and services
(c) Protection of resident funds
(d) Free choice
(e) Privacy and confidentiality
(f) Grievances
(g) Examination of survey results
(h) Work
(i) Mail
(j) Access and visitation rights
(k) Telephone
(l) Personal property
(m) Married couples
(n) Self-administration of drugs
(o) Refusal of certain transfers

ß 483.12 Admission, transfer, and discharge rights

(a) Transfer and discharge
(b) Notice of bed-hold policy and readmission
(c) Equal access to quality care
(d) Admissions policy

ß 483.13 Resident behavior and facility practices

(a) Restraints
(b) Abuse
(c) Staff treatment of residents

ß483.15 Quality of life

(a) Dignity
(b) Self-determination and participation
(c) Participation in resident and family groups
(d) Participation in other activities
(e) Accommodation of needs
(f) Activities
(g) Social services
(h) Environment

ß 483.20 Resident assessment

(a) Admission orders
(b) Comprehensive assessments
(c) Accuracy of assessments
(d) Comprehensive care plans
(e) Discharge summary
(f) Preadmission screening

ß483.25 Quality of care

(a) Activities of daily living
(b) Vision and hearing
(c) Pressure sores
(d) Urinary incontinence
(e) Range of motion
(f) Mental and psychosocial functioning
(g) Naso-gastric tubes
(h) Accidents
(i) Nutrition
(j) Hydration
(k) Special needs
(l) Unnecessary drugs
(m) Medication errors

ß483.30 Nursing services

(a) Sufficient staff
(b) Registered nurse
(c) Nursing facilities: waiver
(d) SNFs: waiver

ß483.35 Dietary services

(a) Staffing
(b) Sufficient staff
(c) Menus and nutritional adequacy
(d) Food
(e) Therapeutic diets
(f) Frequency of meals
(g) Assistive devices
(h) Sanitary conditions

ß483.40 Physician services

(a) Physician supervision
(b) Physician visits
(c) Frequency of physician visits
(d) Availability of physicians for emergency care
(e) Physician delegation of tasks in SNFs
(f) Performance of physician tasks in NFs

ß483.45 Specialized rehabilitative services

(a) Provision of services
(b) Qualifications

ß483.55 Dental services

(a) Skilled nursing facilities
(b) Nursing facilities

ß483.60 Pharmacy services

(a) Procedures
(b) Service consultation
(c) Drug regimen review
(d) Labeling of drugs and biologicals
(e) Storage of drugs and biologicals

ß483.65 Infection control

(a) Infection control program
(b) Preventing spread of infection

ß483.70 Physical services

(a) Life safety from fire
(b) Emergency power
(c) Space and equipment
(d) Resident rooms
(e) Toilet facilities
(f) Resident call systems
(g) Dining and resident activities
(h) Other environmental conditions

ß483.75 Administration

(a) Licensure
(b) Compliance
(c) Relationship to other HHS regulations
(d) Governing body
(e) Required training of nursing aides
(f) Proficiency of nurse aides
(g) Staff qualifications
(h) Use of outside resources
(i) Medical director
(j) Laboratory services
(k) Radiology and other diagnostic services
(l) Clinical records
(m) Disaster and emergency preparedness
(n) Transfer agreement
(o) Quality assessment and assurance
(p) Disclosure of ownership

Part Two

Rules for Conducting the Survey

Part Three

Summary of the Federal Requirements for Long Term Care Facilities

ß 483.1 Basis and Scope
ß 483.5 Definitions
ß 483.10 Resident Rights
ß 493.12 Admission, Transfer and Discharge Rights
ß 483.13 Resident Behavior and Facility Practices
ß 483.15. Quality of Life
ß 483.20 Resident Assessment
ß 483.25 Quality of Care
ß 483.30 Nursing Services
ß 483.35 Dietary Services
ß 483.40 Physician Services
ß 483.55 Dental Services
ß 483.60 Pharmacy Services
ß 483.65 Infection Control
ß 483.70 Physical Environment
ß 483.75 Administration

Part Four

CMS Forms Used by Surveyors

(these pages are not numbered: are sequenced by ascending CMS form number)

CMS Form number

462L Adverse Action Extract for SNFs and NFs
671 Application for Medicare and Medicaid
672 Resident Census and Conditions of Residents
673 Extended/Partial Extended Survey Worksheet
677 Medication Pass Worksheet
801 Offsite Survey Preparation Worksheet
802 Roster Sample Matrix
802P Roster Sample Matrix Provider Instructions
802S Roster Sample Matrix Instructions for Surveyors
803 General Observations of the Facility
804 Kitchen/Food Service Observations
805 Resident Review Worksheet
806A Quality of Life Assessment Resident Interview
806B Quality of Life Assessment Group Interview
806C Quality of Life Assessment Family Interview
807 Surveyor Notes Worksheet
2786M Fire Safety Survey - 2000 Life Safety Code
20014 Notice of Exclusions from Medicare Benefits Skilled Nursing Facility

Index

"

Editorial Reviews

Reviewer:Marcia K Flesner, PhD, RN, MHCA(University of Missouri-Columbia)
Description:The book lists the regulations, guidelines, procedures, and probes used by federal surveyors in certifying nursing homes for participation in Medicare and Medicaid programs.
Purpose:The claim is made that facilities which implement the federal guidelines will have outstanding quality assurance and risk management programs in place. Meeting the federal guidelines is a worthy objective and the book does provide the federal requirements with definitions, interpretive guidelines, and procedures that state surveyors use to evaluate homes during their licensing survey.
Audience:The book is written for employees of long term care facilities and state surveyors. Individuals not familiar with federal LTC standards may find the book difficult to understand because there is no explanation of the terminology used in the regulations.
Features:It lists all the federal requirements that are evaluated by state surveyors during the annual survey visit to nursing homes and for complaint visits. The exhibit section contains forms used by surveyors to gather data during the survey visit. Visually, the format makes the regulations easy to read. If nursing home staff used the book to prepare for a survey, they would be well prepared.
Assessment:Knowing the interpretive guidelines used by surveyors would help nursing home staff to prepare for the annual survey visit. By knowing the definitions in the book, the staff would be better able to defend their decision-making at the home to explain how their actions do comply with the regulations.