CMS has released "significant revisions" to its nursing home surveyor guidance, including requirements for COVID-19 vaccine education, opioid and psychotropic prescribing, and medical director responsibilities.
State survey agencies are expected to begin using the revised guidance beginning Feb. 24, according to a Nov. 28 CMS memorandum.
Here are seven key takeaways from the revisions:
- Language: Revisions were made to the language used in the guidance for admission agreements and the levels of assistance a resident receives for self-care and mobility activities.
- Medications: Guidance was added for treating patients with psychotropic medication, including the resident's right to refuse treatment. CMS also included guidance on determining noncompliance over antipsychotic medication use. Revisions were made to the definitions of acute, chronic and subacute pain, as well as to opioid prescription guidance.
- Professional standards: Clarification was given over the medical directors' role in regard to the documentation of antipsychotic medication use. CMS also clarified the medical directors' responsibilities related to the implementation and coordination of resident care policies.
- Environment: Revisions were made to allow certain exceptions for meeting facility requirements and to include infection control guidance for the prevention of multidrug-resistant organisms' spread.
- Health equity: Guidance was added to incorporate health equity concerns related to outcomes of sub-populations.
- Care and safety: CPR certification updates were made to align with national standards and COVID-19 immunization education requirements for residents were incorporated.
- CMS has updated guidance training for nursing home surveyors and providers on the Quality, Safety, and Education Portal.
Read the full memorandum here.