The new Risk-Based Survey (RBS) significantly changes the facility tasks surveyors are required to complete during an annual survey. While the traditional Long-Term Care Survey Process includes nine mandatory facility tasks, the RBS includes only the Infection Control mandatory task. The remaining facility tasks are triggered based on information identified offsite through Ombudsman concerns, active intakes, or onsite through resident concerns and surveyor observations.
Under the RBS, Infection Control is assigned to all surveyors, with one surveyor designated as the primary. Surveyors are instructed to conduct observations of general standard precautions, hand hygiene, appropriate use and donning and doffing of personal protective equipment (PPE), and Transmission-Based Precautions (TBP). When concerns are identified, surveyors may interview staff, review applicable policies and procedures, and interview the Infection Preventionist regarding how staff compliance with infection control practices is monitored.
Transmission-Based Precautions are also specifically incorporated into the RBS screening process. When the CMS-802 identifies three or more residents with the same facility-acquired infection who are on TBP, surveyors are instructed to include one resident per infection type in screening across the team. Surveyors may also identify residents on TBP while walking the units and ask nursing staff about the type of infection to determine whether the screening criteria are met. In smaller facilities with a census of 1–30 residents, the Director of Nursing may be asked to immediately identify residents with current facility-acquired infections requiring TBP while the CMS-802 is being provided.
LeadingAge Ohio encourages providers to become familiar with the Risk-Based Survey Resources found on the CMS Nursing Home webpage, located in the Survey Resources zip file.