Under the Risk-Based Survey (RBS) process, resident screening is targeted toward specific high-risk concerns identified offsite, on the CMS-802, or through surveyor observations onsite. The RBS prioritizes residents with Stage 3, 4, or unstageable pressure ulcers not present on admission; falls with major injury within the past 120 days; and tube feeding with weight loss and/or dehydration within the past 180 days.
Resident screening also includes one resident for each identified hospice, dialysis, or ventilator service across the team. When three or more residents have the same facility-acquired infection and are on Transmission-Based Precautions (TBP), one resident per infection type is included. Residents on Enhanced Barrier Precautions do not meet this TBP screening criterion. Surveyors may also add residents based on serious observations, such as potential abuse or uncontrolled pain.
While surveyors are not required to enter every resident room under the RBS, they are instructed to observe as many residents as possible efficiently, such as during meals, group activities, or while walking the units to identify serious concerns that may warrant further screening. Screening is used to identify the residents with the most and/or most serious concerns that have a high likelihood of resulting in deficient practice. Understanding the RBS resident screening process allows facilities to anticipate which residents on the CMS-802 may meet screening criteria and ensure the information used to identify those residents is accurate and readily available.