Instead, CMS set out to create one efficient and comprehensive survey that gives surveyors more of the leeway they enjoyed in the traditional survey, while benefitting from the structure and comprehensive nature of the QIS. Similar to QIS, the new LTCSP will cover all areas of care in the regulation in a standardized and computerized format. The LTCSP also will utilize the Critical Element Pathways that were developed for QIS, although these pathways are now updated to reflect changes from the final rule.
In contrast to the QIS, the LTCSP will not use statistical thresholds to determine what areas get further investigation. Rather, this decision is left up to the surveyors and is made after an Initial screening-, structured Resident Interviews, Family Interviews, Resident Observations and limited closed-record reviews. The screening questionnaires will cover every care area, and the responses garnered will determine whether the surveyor investigates each care area further.
2. Consider your readiness strategy.
The first step to preparing for the new survey is to examine your existing survey-readiness strategy. Do you have a way to collect data on every area of care through interviewing and observing your residents? As you consider your strategy, be sure to view everything through the resident’s eyes. The new survey process is similar to QIS in that it is very resident-centered; resident-specific concerns are identified through resident observations and resident or representative interviews. Before the survey, work with and interview all staff, residents and families to become familiar with and address their viewpoints.
In addition, the published thresholds from QIS—although not used in this new survey—still present a data-driven way to predict issues that have a high likelihood of further investigation. You can also utilize the published Critical Element (CE) Pathways to your advantage. These in-depth investigation protocols that your surveyors will use for each care area are publicly available. Use the same pathways when investigating your own compliance.
Also consider that high-risk care areas such as Abuse, Pain, Dental, Pressure Ulcers and Accidents will be investigated if any Initial Pool resident gives a negative answer. As such, it’s a safe strategy to assume that all areas will be investigated and run through the CE Pathways ahead of time.
Finally, keep in mind that collecting feedback from residents, families and staff is now a requirement under the Quality Assurance and Performance Improvement (QAPI) regulations. There’s no sense doing double work; consider periodically conducting interviews and collecting observations that will cover all care areas and you will be conducting QAPI while remaining ready for survey.