Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

It seems like we are always in a “survey window,” waiting for the inspectors to arrive. Are there different types of surveys?

I know, it seems as though nurse leaders are always preparing for a survey, being surveyed or waiting for surveyors to return. Let me clarify the possibilities:

Standard survey the “annual survey,” conducted on a nine- to 15-month cycle, with 10% beginning on a weekend or an off-shift.

Abbreviated standard survey triggered by a complaint or a change in ownership, management or DON.

Extended survey conducted if substandard quality of care is found in the F-Tags that fall under §483.13 Resident Behavior and Facility Practices, §483.15 Quality of Life, or §483.25 Quality of Care. 

Partial extended survey triggered by substandard quality of care found during an abbreviated standard (complaint) survey.

Post-survey revisit or follow-up survey can be an onsite visit to verify correction of specific deficiencies from a prior survey, or can be a desk review.

During a survey, they look at the categories of isolated, patterned or widespread problems using a matrix. 

Immediate Jeopardy to resident health or safety has levels: J, K and L.

Actual harm that is not immediate: G, H and I. No actual harm with potential for more than minimal harm that is not Immediate Jeopardy: D, E and F.

No actual harm with potential for more than minimal harm that is not immediate jeopardy: A, B and C.

Depending on if they find, say, an infection prevention problem, you could receive a C. However, if they find someone in a coma because of an infection problem, or 10 residents have pink eye and they all sit at the same dining room table, they could give an Actual Harm with a G, H or I.