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New CMS focused dementia care tools for surveyors

On November 27th 2015, CMS issued a new survey and certification memo, based on the Focused Dementia Care Survey Pilot in 2014 and the 2015 initiative to test the survey type in a few more states. This new survey type examined and puts greats focus on quality of care provided to patients living with dementia. Nursing home antipsychotic medications prescription and other dementia care compliance regulation are targeted and provide support in advancing care for the older adults.

The intent is that facilities can use these tools to assess their own practices in providing resident care. In addition to the greater risk for nursing homes operator, it highlights the need for better life enrichment and person centered care.

The survey toolkit includes 4 parts, with the first 3 parts being completed for the nursing homes, the 4th part being resident specific. These sections are:

Part 1 – Nursing Home Characteristics

Part 2 – Dementia Care – Policies, Leadership, Training, Documentation

Risk: F498. F490 or F520

Part 3 – Quality Assessment and Assurance (QAA)

Risk: One or more “no” responses in this Quality Assurance and Assessment section potentially indicative of non-compliance in relation to 42 CFR 483.25 and F309.

Part 4 is completed for each resident that is sampled. The expectation is that 5 residents will be sampled for medium-sized facilities of 120-150 beds, and that for 150+bed facilities or facilities that have dementia-care related citations at F-309, the sample may be expanded to 10 residents. The sections in Part 4 are:

  • Dementia Care & Related Practices

  • Comprehensive Evaluation of Each Resident on Admission by the Interdisciplinary Team

  • Recognition, Assessment and Cause Identification of Behavioral Manifestations of Dementia

  • Care Planning

  • Individualized Approaches and Treatment: Care Plan Implementation and Staffing

  • Monitoring, Follow-up and Oversight

Risk: The tool also reminds surveyors that if the nursing home has not provided care and services for each resident with dementia to support his/her highest practicable level of physical, mental and psycho-social well-being in accordance with the comprehensive assessment and plan of care that F-309 should be cited.

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