The Centers for Medicare & Medicaid Services has turned up the heat again on providers with new guidance that directs surveyors to take a more critical look at nurse competency and residents’ quality of care. 

The Nov. 10 issuance was in direct response to criticism from some sectors that CMS and state survey agencies hadn’t been able to exert a traditional level of visibility and check-ups during the pandemic. 

Surveyors are being directed to pay special attention to nurse staff abilities and actions, use of antipsychotics, and areas of care where residents’ health and safety may be at an increased risk. That means having a more critical eye on unplanned weight loss, loss of function/mobility, depression, abuse/neglect and pressure ulcers. 

The new memo also laid out steps to address the backlog of complaint and recertification surveys.

States that fail to perform certain survey activities “timely and completely” could forfeit up to 5% of their federal COVID-19 relief funding.