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CMS details 5 new scenarios that trigger infection control-focused surveys

Multiple weeks with new coronavirus cases or low staffing are among the additional scenarios that will trigger a focused infection control survey at a nursing home, the Centers for Medicare & Medicaid Services announced today.

CMS revised the criteria that requires states to conduct the specific surveys, the agency in a memo to state survey agencies.

Since June, CMS has required states to perform onsite infection control-focused surveys by the end July at nursing homes with previous COVID-19 outbreaks, or within three to five days of any nursing home with three or more new confirmed cases since their last report to the National Health Care Safety Network.

The agency on Monday added five other factors that would trigger a survey for providers. In addition to multiple new cases and low staffing, other new factors include, facilities that were selected for Special Focus Facility Design; if there are concerns related to conducting outbreak testing; or if there are any "Immediate Jeopardy" allegations or complaints against the facility.

CMS added that it will work with state surveyors to identify facilities that meet the additional triggered criteria.

“Facilities that meet the criteria above to trigger a FIC (focused infection control) survey do not need to be resurveyed if a FIC survey was conducted (as a stand-alone FIC survey or as part of a recertification survey) within the previous three weeks," CMS explained.

“For example, if a facility is surveyed with a FIC survey within three to five days after meeting the criteria, and the same facility meets the criteria for being surveyed within three to five days in any of the next three weeks, the survey team does not need to conduct another survey within those three weeks. However, if the facility meets the criteria for a survey in the fourth week after a FIC survey was conducted, an additional FIC survey must be conducted within three to five days," the agency explained.

CMS also noted that when conducting the focused infection control surveys, long-term care facility surveyors “should be alert to, and investigate any concerns related to residents who have had a significant decline in their condition (e.g., weight loss, mobility) during the public health emergency.


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Curt Wood, R.Ph., FASCP

Board Certified Geriatric Pharmacist

Elder Care Pharmacy Consultants take pride in being truly independent. Elder Care Pharmacy Consultants, LLC. has a comprehensive approach to antipsychotic use in order to help ensure nursing homes reach their goals, enhance star quality measures, and maintain federal and state compliance. Our success depends on your satisfaction with the services we provide..

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