SURVEY INTERVIEW AND OBSERVATION QUESTIONS & PROBES
- State Survey RESIDENT OBSERVATION Care Areas and Probes
- State Survey RESIDENT INTERVIEW Care Areas and Probes
- State Survey FAMILY (Resident Representative) INTERVIEW Care Areas and Probes
- State Survey RECORD REVIEW Care Areas and Probes (Updated March 2025)
- State Survey Initial Pool Mapping Document (Updated July 2025)
- State Survey List-of-Revised-FTags (Updated April 2025)
- Infection Prevention, Control and Immunization Survey Audit Form (Updated by CMS July 2025)
- Initial Certification Tag Review Document (Updated April 2025)
OTHER TOOLS AND RESOURCES
- Survey Preparation Tool for Therapy Staff
- LTC Survey Process Procedure Guide (New July 2025)
- Timeline of Updates to Survey Process
- State Survey Entrance Conference Form
- State Survey – CMS Form 672 – Census & Conditions: Data Collection and Instructions (Discontinued 10/1/23)
- State Survey – CMS Form 802 – Matrix Data Collection and Instructions
Survey Resources (ZIP) (Updated April 2025) Revision History for LTC Survey Process (Updated April 2025) - Scope and Severity Grid
- State Operations Manual – Main Page
- SOM Chapter 7 – SNF Survey Rules and Process
- Appendix PP State Operations Manual (Updated July 2025 with MAJOR CHANGES)
CRITICAL ELEMENT PATHWAYS: FORMS SURVEYORS USE TO AUDIT EACH AREA
PRINT / SAVE INDIVIDUAL PATHWAYS FROM LIST BELOW: (Last updated by CMS July 2025)
- SNF Beneficiary Protection Notifications NOMNC ABN
- Dining Observation
- Infection Prevention, Control & Immunizations
- Kitchen Observation
- Medication Administration Observation
- Resident Council Interview
- Quality Assessment and Assurance (QAA) and Quality Assurance and Performance Improvement (Updated March 2025)
- Abuse
- Environmental Observations
- Sufficient and Competent Nurse Staffing Review (Updated March 2025)
- Personal Funds Review
- Activities
- Activities of Daily Living (ADL)
- Behavioral and Emotional Status
- Urinary Catheter or Urinary Tract Infection (New April 2024)
- Communication and Sensory Problems (Includes Hearing and Vision)
- Dental Status and Services (New April 2024)
- Dialysis (New April 2024)
- General Care
- Hospice and End of Life Care and Services
- Death
- Nutrition
- Pain Recognition and Management (Updated March 2025)
- Physical Restraints
- Pressure Ulcer/Injury (New April 2024)
- Specialized Rehabilitative or Restorative Services
- Respiratory Care (Updated March 2025)
- Unnecessary Medications, Psychotropic Medications, and Medication Regimen Review (Updated March 2025)
- Medication Storage and Labeling
- Preadmission Screening and Resident Review
- Extended Survey
- Hydration
- Tube Feeding Status (New April 2024)
- Positioning, Mobility & Range of Motion
- Hospitalization (Updated March 2025)
- Bladder or Bowel Incontinence
- Accidents (Updated March 2025)
- Neglect
- Resident Assessment MDS (Updated March 2025)
- Discharge Planning (Updated May 2025)
- Dementia Care
- Arbitration
LTC SURVEYOR GUIDANCE – NEW INFORMATION for 2025 and 2026
- ***Revised Long-Term Care (LTC) Surveyor Guidance: Significant revisions to enhance quality and oversight of the LTC survey process – 902-Page Memorandum Issued by CMS November 18, 2024 for Implementation FEBRUARY 2025
- CMS will publish these updates in Appendix PP of the State Operations Manual (SOM) in February 2025 for State Survey Agencies (SAs), long-term care facilities, and the public to understand how compliance will be assessed. This guidance will also be available to surveyors in the Automated Survey Process Environment (ASPEN) system starting February 24, 2025. Surveyors will begin using the guidance to determine compliance at that time.
- THE ABOVE WAS DELAYED UNTIL APRIL 28, 2025
- Each Critical Element Pathway that was updated as a result of the MAJOR CHANGES in March are identified above
LINK TO CMS MEMO: CMS MEMO Ref: QSO-25-14-NH
New Changes for 2026
CMS issued QSO-26-03-NH with changes for Survey, Survey Enforcement and Complaint Procedures. Changes to Chapter 5 and Chapter 7 of the CMS State Operations Manual (SOM) were made. The link will take you to the document that has all the changes (noted in red).
Full CMS Document: https://www.cms.gov/files/document/qso-26-03-nh-original-release-date-2026-01-30.pdf
Summary of Changes: https://www.monterotherapyservices.com/mp-files/summary-of-snf-survey-changes-for-march-30-2026.pdf/
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