CMS has released updated guidance on the frequency of focused infection control (FIC) surveys as well as providing frequently asked questions (FAQs) regarding health, emergency preparedness (EP), and life safety code (LSC) surveys.
Updated FIC Guidance
CMS will continue to require state agencies to conduct onsite FIC surveys within three to five days of identification of a facility with three or more new confirmed COVID-19 cases or one confirmed case in a facility that was previously COVID-free. However, CMS is updating this guidance to require states to also consider additional factors to determine whether to conduct a FIC, such as multiple weeks with new COVID cases, low staffing levels, and allegations or complaints related to concerns of abuse or quality of care such weight loss and decline in functioning. CMS adds that during FIC surveys, surveyors should investigate concerns related to residents that have had a significant decline in condition such as weight loss or mobility. Providers should continue to proactively monitor any of these quality of care concerns including quality measure indicators and document their efforts through their quality improvement processes.
In addition, CMS is limiting the frequency of FIC surveys, stating that facilities that have had a FIC in the past three weeks—whether a standalone FIC survey or as part of a recertification survey—do not need to be re-surveyed if they meet the criteria to be surveyed again within a three-week period. However, a facility could be re-surveyed in the fourth week or thereafter.
Survey FAQs
CMS also included several FAQs regarding health, EP, and LSC surveys. The FAQs provide guidance on several topics, such as:
- Protocols for surveyors to follow while onsite, including:
- Wearing appropriate PPE supplied by the state agency;
- Adhering to practices for COVID-19 infection prevention including screening;
- Not entering facilities when experiencing signs and symptoms of infection; and
- Assigning separate surveyors to COVID-19 residents or wings, residents under observation, and not moving between these areas of the building.
- Information on modifications to certain elements of the survey, such as the resident council interview and dining tasks, to prevent COVID spread.
- Adjustments to EP and LSC survey procedures during the PHE, such as the facility tour and records review, and not citing providers for ITM activities that have been waived during the PHE. (Note: Facilities with ITM deficiencies that cannot be corrected due to vendor access restrictions during the PHE should request temporary LSC waivers, as applicable, as part of their POC.)
The FAQs also note that while facilities may offer to test surveyors for COVID-19 prior to entry, they cannot require testing or proof of testing as a condition for surveyors entering. Further, CMS states that while surveyors should attempt to safely complete the survey process, including resident interviews in person, they should use opportunities to conduct additional survey activities such as additional phone interviews, record or document reviews, and exit conference, offsite.
The memo also includes a list of F-tags and K-tags waived or partially waived through 1135 waiver authority during the PHE.
We encourage you to review these FAQs, which are attached to the CMS memo, in greater detail. If you have any questions, please email COVID-19@ahca.org.