When it comes to investigating nursing home abuse, there are a few safeguards already in place. Though without strict rules and requirements around those safeguards, it is hard to know if they are effective. In November 2024, the Centers for Medicare and Medicaid Services (CMS) revised the guide for nursing home surveyors. With the addition of more revisions in January 2025, the guidance goes into effect in March 2025. Below are some of the key changes that all states and surveyors are required to enforce.
What is a Nursing Home Surveyor?
Based on a job description from a Pennsylvania government site, the surveyor is responsible for conducting “on-site surveys by observing health care service delivery, interviewing staff and clients, and reviewing medical records to ensure patients receive safe and appropriate care and services.”
Essentially, surveyors are one in a line of defense, ensuring nursing homes are transparent with their citations, efficient with their care, and up-to-date with licensure and procedures.
Updated Nursing Home Survey Requirements
Within the requirements they have outlined and further defined “licensed nurse”, “charge nurse” and “scope of practice”. They also included that facilities will be required to provide 24/7 licensed nursing staff.
A provision for discharges and transfers was also added. New language was added to require facilities to create policies that allow them to accept residents back into the facility after a hospitalization or therapeutic stay. As directed by the new guidelines, surveyors are to “Review the history of complaints and survey history for indications of noncompliance.”
Psychotropic Drug Use & Comprehensive Care Plans
Perhaps the two most important parts of the new guidelines involved the use of psychotropic drugs and the establishment of comprehensive care plans.
Under the new regulations, CMS is aiming to further reduce the use of psychotropic drugs for chemical restraint. “Evidence suggests that the decline in antipsychotic drug use was likely attributable to the exclusion of individuals diagnosed with schizophrenia from the residents counted. As a result of this exclusion, there was a steady increase in schizophrenia diagnoses.”
The new guidelines outline that facilities must investigate before administering psychotropic drugs. Surveyors are to “review the medical record to determine whether the prescribing practitioner provided a rationale.”
Finally, comprehensive care was addressed. Specifically, the new requirement includes that facilities must receive a mental health diagnosis from a medical professional who has used the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sufficient documentation is required, including a record of changed behaviors, other symptoms, and the resident’s relational function. Surveyors will be required to review all data gathered on residents to confirm that the right care is provided and there is sufficient documentation to justify a mental disorder diagnosis.
Conclusion
As one of nursing home residents’ best protection against insufficient policies, poor care, and lack of transparency, surveyors serve a vital role in ensuring quality resident care. These new regulation will, hopefully, help them better investigate all instances that could be deemed abusive or negligent.
To read the full updated guidelines visit the CMS fact sheet.
If you or a loved one have been the victim of nursing home abuse or neglect, call Gharibian Law (866-239-8812) today for a FREE consultation and the best legal representation.
In the News: Updated Nursing Home Survey Requirements
When it comes to investigating nursing home abuse, there are a few safeguards already in place. Though without strict rules and requirements around those safeguards, it is hard to know if they are effective. In November 2024, the Centers for Medicare and Medicaid Services (CMS) revised the guide for nursing home surveyors. With the addition of more revisions in January 2025, the guidance goes into effect in March 2025. Below are some of the key changes that all states and surveyors are required to enforce.
What is a Nursing Home Surveyor?
Based on a job description from a Pennsylvania government site, the surveyor is responsible for conducting “on-site surveys by observing health care service delivery, interviewing staff and clients, and reviewing medical records to ensure patients receive safe and appropriate care and services.”
Essentially, surveyors are one in a line of defense, ensuring nursing homes are transparent with their citations, efficient with their care, and up-to-date with licensure and procedures.
Updated Nursing Home Survey Requirements
Within the requirements they have outlined and further defined “licensed nurse”, “charge nurse” and “scope of practice”. They also included that facilities will be required to provide 24/7 licensed nursing staff.
A provision for discharges and transfers was also added. New language was added to require facilities to create policies that allow them to accept residents back into the facility after a hospitalization or therapeutic stay. As directed by the new guidelines, surveyors are to “Review the history of complaints and survey history for indications of noncompliance.”
Psychotropic Drug Use & Comprehensive Care Plans
Perhaps the two most important parts of the new guidelines involved the use of psychotropic drugs and the establishment of comprehensive care plans.
Under the new regulations, CMS is aiming to further reduce the use of psychotropic drugs for chemical restraint. “Evidence suggests that the decline in antipsychotic drug use was likely attributable to the exclusion of individuals diagnosed with schizophrenia from the residents counted. As a result of this exclusion, there was a steady increase in schizophrenia diagnoses.”
The new guidelines outline that facilities must investigate before administering psychotropic drugs. Surveyors are to “review the medical record to determine whether the prescribing practitioner provided a rationale.”
Finally, comprehensive care was addressed. Specifically, the new requirement includes that facilities must receive a mental health diagnosis from a medical professional who has used the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sufficient documentation is required, including a record of changed behaviors, other symptoms, and the resident’s relational function. Surveyors will be required to review all data gathered on residents to confirm that the right care is provided and there is sufficient documentation to justify a mental disorder diagnosis.
Conclusion
As one of nursing home residents’ best protection against insufficient policies, poor care, and lack of transparency, surveyors serve a vital role in ensuring quality resident care. These new regulation will, hopefully, help them better investigate all instances that could be deemed abusive or negligent.
To read the full updated guidelines visit the CMS fact sheet.
If you or a loved one have been the victim of nursing home abuse or neglect, call Gharibian Law (866-239-8812) today for a FREE consultation and the best legal representation.