488.110Procedural guidelines.#
SNF/ICF Survey Process. The purpose for implementing a new SNF/ICF survey process is to assess whether the quality of care, as intended by the law and regulations, and as needed by the resident, is actually being provided in nursing homes. Although the onsite review procedures have been changed, facilities must continue to meet all applicable Conditions/Standards, in order to participate in Medicare/Medicaid programs. That is, the methods used to compile information about compliance with law and regulations are changed; the law and regulations themselves are not changed. The new process differs from the traditional process, principally in terms of its emphasis on resident outcomes. In ascertaining whether residents grooming and personal hygiene needs are met, for example, surveyors will no longer routinely evaluate a facility's written policies and procedures. Instead, surveyors will observe residents in order to make that determination. In addition, surveyors will confirm, through interviews with residents and staff, that such needs are indeed met on a regular basis. In most reviews, then, surveyors will ascertain whether the facility is actually providing the required and needed care and services, rather than whether the facility is capable of providing the care and services. The Outcome-Oriented Survey Process—Skilled Nursing Facilities (SNFs) and Intermediate Care Facilities (ICFs) (a) General. (b) The Survey Tasks. (c) Task 1—Entrance Conference. (d) Task 2—Resident Sample—Selection Methodology. (e) Task 3—Tour of the Facility. (f) Task 4—Observation/Interview/Medical Record Review (including drug regimen review). (g) Task 5—Drug Pass Observation. (h) Task 6—Dining Area and Eating Assistance Observation. (i) Task 7—Forming the Deficiency Statement. (j) Task 8—Exit Conference. (k) Plan of Correction. (l) Followup Surveys. (m) Role of Surveyor. (n) Confidentiality and Respect for Resident Privacy. (o) Team Composition. (p) Type of Facility-Application of SNF or ICF Regulations. (q) Use of Part A and Part B of the Survey Report.