COVID restrictions are easing across the country, but that doesn’t mean surveys will—especially with the government’s recently announced focus on long-term care. In November 2021, the Centers for Medicare and Medicaid Services (CMS) instructed surveyors to critically evaluate nurse competency and quality of care.

The increased focus on quality of life comes in response to concerns that CMS and agency surveyors could not adequately assess the quality of care and compliance throughout the ongoing pandemic. CMS also directed surveyors to look at the use of antipsychotics and potential abuse and neglect issues. They will be looking for unexpected weight loss, loss of mobility or function, pressure ulcers, and depression in long-term care residents.

CMS said that “specialized attention should be given to facilities exhibiting higher infection rates but lower COVID-19 vaccination rates.” The agency is addressing the backlog of complaint and recertification surveys by:

• Revising the criteria for COVID Focused Infection Control (FIC) surveys
  • CMS no longer requires FIC surveys to be conducted within 3-5 days of a community having 3+ new confirmed COVID cases.
  • Surveyors must perform annual FIC surveys for 20% of nursing homes, where communities with low vaccination rates are prioritized.
• Revising guidance for resuming recertification surveys
  • Recertification surveys will resume regularly with new intervals based on each community’s next survey, not the last survey conducted before the pandemic.
  • These surveys are prioritized based on the potential risks to residents.

States that do not adhere to stricter survey guidelines “timely and completely” risk losing up to 5% of their CARES act relief funding.

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