Many of CMS’s 2025 Surveyor Guidance Updates refer to the diagnoses of mental disorders and the corresponding usage of psychotropics to treat those disorders, but there are other significant changes. Here’s a sampling of what you’ll find in our free guide, “The Administrator's Guide to CMS’s 2025 Surveyor Guidance Updates.”
Admissions agreements will be examined
Only residents bear any personal financial responsibility for the payment of their care. Third-party payors (such as insurance) are exempted.
The PBJ Staffing Data Report will be used in determining whether a facility has sufficient nursing coverage
Surveyors consider many factors when determining whether a facility has sufficient nursing coverage for its residents. The tools they use include the facility assessment, resident assessments and resident plans of care.
With this update, CMS has named the PBJ Staffing Data Report as another tool to be used and lined out the ways in which it will be used, saying it “provides very clear and distinct areas that could identify deficient practices, along with “specific infraction dates.”
Inappropriate discharges and transfers have been further defined
Determining inappropriate discharges is a complex, layered process. CMS’s updates offer further guidance about what constitutes inappropriate discharges and transfers. Proper documentation is key, as is understanding the guidelines that surveyors will be following.
Medical directors have new responsibilities
CMS has added language to clarify medical director responsibilities in long-term care facilities. In addition, it has highlighted the medical director’s role in ensuring that diagnoses of mental disorders and the usage of psychotropics in their treatment correspond to current professional standards.
Accuracy of assessments
Facilities must ensure that MDS Assessments and Corrections accurately reflect each resident's status and meet all regulatory requirements to avoid allegations of fraud or noncompliance. One or two incidents of misreporting will be considered isolated, and three or more will be considered widespread, at the discretion of the surveyor.
Additional updates
Additional updates have been made to CMS Surveyor Guidance for Chemical Restraints/Unnecessary Psychotropic Medication; Cardio-Pulmonary Resuscitation (CPR); New QAPI/QAA Measure; Pain Management; Physical Environment; Infection Prevention and Control; and COVID-19 Immunization.
Download our free guide
In our free guide, you’ll get additional information about the changes, handy links to the relevant F-tags, and compliance tips that can help you ace your next CMS survey. All pulled together by an LNHA with 20 years of experience navigating CMS surveyor guidance updates.
