How A Nursing Home Surveyor Conducts The Nursing Home Survey - Part 1
As with hospitals, skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to be in compliance with their requirements, which are located at 42 CFR Part 483, Subpart B, in order to receive payment under the Medicare or Medicaid programs. Unlike hospitals, SNFs and NFs have two types of standard surveys. The traditional survey and the quality indicator survey (QIS) are the two types. The QIS survey is the “new kid” on the block and CMS developed it to try and improve the quality and consistency of nursing home surveys. Both types are currently accepted by CMS to evaluate compliance of nursing homes with their requirements.
Currently, most states are using the traditional survey. QIS training is intensive, long, and only CMS-approved training agencies and training materials may be used by the States to train their surveyors in the new process. It is also a much more expensive survey to conduct because of the cost of the training and the computers needed. This is one reason why it has not been pushed as extensively as CMS would like.
The QIS is intended to be implemented as a replacement for the current (Traditional) survey process. The QIS has two-stages and the process has a computer component to it. Stage 1 consists of computer analysis of offsite data as well as computer analysis of the data collected by surveyors from observations, interviews, and record reviews of large computer-selected resident samples. Stage 2 of the QIS consists of systematic surveyor investigations of specific issues and residents using the Guidance to Surveyors as well as a set of detailed investigative tools, called critical elements protocols. In addition to the two Stages there are also several facility-level tasks that are completed either on every survey or when the task is considered an area of concern.
The Stage 1 information is analyzed by the surveyors computer and a set of approximately 160 Quality of Care Indicators (QCIs) are the result of the analysis. These QCIs are used to compare the nursing facility being surveyed to national norms. Any QCIs that score beyond a particular statistical threshold are then computer-selected for a Stage 2 review. The computer also selects a sample of relevant residents.
As with Hospital surveys, the nursing home surveyor and the team will arrive at the facility unannounced. As with the Hospital surveys, the nursing facility surveys may be conducted at any time including weekends, 24 hours a day.
We will continue this in the next post.
Be Safe! Be Knowledgable!
JL
Filed Under Nursing Homes, Regulations, Survey Task |
Tagged With Nursing Homes, SOM, State Operations Manual, Survey, Survey Instructions, Survey tasks, Surveyor
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3 Responses to “How A Nursing Home Surveyor Conducts The Nursing Home Survey - Part 1”
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Either way, whether Traditional Survey or Quality Indicator Survey, what appears on the CMS nursing home Compare website that is labeled “quality measures” is based on self-reported, unaudited data, data reported by the facilities themselves and unverified by any oversight agency (DOH or CMS) to ensure it is even true. This leads nursing staff to do charting by rote, instead of charting care that they’re actually giving.
When the Bush administration’s “de-regulation” failed, they wanted the Quality Indicator process to eventually replace Traditional Surveys because it relies upon those self-reported, unaudited data supplied by the facilities themselves and is without consequences for failures.
It is a “warm-n-fuzzy” we’ll help them fix their problems, even though 99% of their failures are failures of practices they should already be experienced in before they are granted a license. It is part of a “kid-gloves, don’t be so hard on the poor nursing home” B.S.
Nursing home care falling short
http://talk.baltimoresun.com/showthread.php?t=147677
they should be concerned about short staffing in some facilities aides who are rushed in giving care caused by adding more items to do on their list of activities. cut their carring for residents psyco needs as to speak to them ,carry on daily comunication which helps them carry on a day to day living statice.such as::good morning mrs jones it’s cold outside,the weather is suppose to change today and get warmmer. how do you feel today? is there anything i can get you today?just ring and one of us will assist you have a good day. but everything is quick and to the point!question is would you like this quick abrubt care giver!!!!!!