Regulations

CMS updates guidance for surveyors

Nursing home surveyors should question staff members to ensure that residents’ care is aligned with their advance directives, according to a manual update recently released by the Centers for Medicare & Medicaid Services. The document released Wednesday includes revised guidance for more than 20 F-Tags, including those related to dementia care, restraints and nasogastric tubes.

The section on F-155 is one of the most heavily revised. It includes updated investigative protocols which advise surveyors to question how a facility determines whether a resident has an advance directive, how it follows these directives, and whether it periodically reassesses them.

Another revised portion of the manual addresses quality of care for residents with dementia, including potentially warranted use of antipsychotic medications.

All the changes are to Appendix PP of the State Operations Manual, and reflect guidance that has been issued via Survey & Certification memoranda between fiscal year 2003 and May 2014.