Evan Shulman
Evan Shulman

The new survey process for skilled nursing facilities is expected to be made more efficient by drawing on the strengths of two existing processes, Centers for Medicare & Medicaid Services officials said Thursday.

Evan Shulman, CMS Deputy Director in the Division of Nursing Homes, shared the agency’s methodology in creating the new process during a call covering the recently revamped requirements for long-term care providers.

Creation of the new process, first announced in late September, included an analysis of the differences between the current Quality Indicator Survey and the traditional survey process, Shulman said. Those differences includes the computer-based QIS generally being better at identifying unnecessary medications, while traditional, paper-based surveys are better equipped to identify infection control issues.

“We’ve been looking at the best practices, or what can we leverage to improve the survey process overall,” Shulman said. “We think that one survey process may create more efficiency.”

The updated survey partially was spurred by the reformed requirements for long-term care facilities, Shulman noted. The new survey process will go into effect on Nov. 28, 2017, although facilities being surveyed after Nov. 28, 2016 will be examined on whether they have completed Phase 1 regulations in the final rule.

“When you put all of this together it really compels us to look at and revise the survey process,” Shulman said. “With all of these things happening at the same time, we felt it was natural to have the new survey process launch along with Phase 2 of the new regulations.”

The new process will be computer based, and split into two parts: a sample selection, comprised of 70% offsite and 30% onsite work, followed by an investigation. The launch of the new process mean changes to the F-tag system, Shulman warned, with some tags splitting into more than one tag and others being combined.

Training on the new tags and regulations will be offered to providers, officials said, beginning with a recorded webinar highlighting Phase 1 changes and updated tags that will become available on Nov. 18. Phase 1 for implementation of the new regulations for long-term care facilities is set to begin on Nov. 28.