News, Skilled Nursing Facility

CMS releases new facility assessment tool

Last week, CMS provided information about its new facility assessment tool during an MLN Connects call and presentation. The tool, which is optional and can either be used as is or adapted by nursing home providers, provides a template for facilities to use when conducting their facility-wide assessment, which is a new requirement under Phase 2 of the Reform of Requirements for Long-Term Care Facilities final rule.

The presentation reviewed:

  • Tool requirement and intent
  • Tool overview, development process, and pilot
  • Closer look at the tool (walk through each section)

The tool includes three parts to help facilities conduct a compliant facility assessment:

  1. Resident profile
  2. Services and care
  3. Facility resources needed to provide competent care

The tool also includes two attachments:

  1. Regulatory mentions of the facility assessment
  2. Sample process for conducting the assessment

CMS emphasizes that facilities should take a customized approach to using this tool in order to accommodate the significant variations that exist in long-term care facilities, while also ensuring that the assessment “addresses or includes the factors or items set forth in §483.70(e).”

Finally, the presentation clarifies revisions to Appendix PP of the State Operations Manual, including guidance on the following sections:

  • §483.12 Freedom from Abuse, Neglect, and Exploitation
    • Requirements for reporting suspected crime vs. alleged violations
    • Serious bodily injury defined
  • §483.15 Admission, Transfer, and Discharge
    • Facility-initiated and resident-initiated transfers and discharges defined
    • When a copy of transfer/discharge should be sent to ombudsmand
  • §483.21 Comprehensive Resident Centered Care Plans
    • Meeting the 48-hour requirement on the weekend
    • BCP guidance
  • §483.45 Pharmacy Services
    • PRN orders for psychotropic and anti-psychotic medications
  • §483.60 Food and Nutrition Services
    • Qualified dietitian
  • §483.75 QAPI
    • What needs to be in place now
    • What changes will go into effect on November 28, 2017
    • QAPI template and additional resources
  • §483.80 Infection Control
    • F881, Antipsychotic stewardship program
    • F757, Unnecessary drugs
    • Infection preventionist