08/24/2023

Survey Tip of the Week: Pain Management

The pain management F-tag 697 states that a facility must ensure that pain management is provided consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences. The Centers for Medicare & Medicaid Services (CMS) added regulatory guidance on the use of opioids for pain management. CMS states when treating pain in a resident with an addiction history or opioid use disorder (OUD), strategies must be used to relieve pain while also considering the OUD or addiction history. These strategies may include continuation of medication assisted treatment (MAT), if appropriate, non-opioid pain medications, and non-pharmacological approaches. Additional CMS added guidance on recommended assessment items, pain management, and monitoring can be found in the State Operations Manual Appendix PP. 

The Long-Term Care Survey Process (LTCSP) instructs surveyors to interview residents about their pain. The questions outlined in the LTCSP resident interview pathway includes: 

• Do you have any pain or discomfort?
• Where is your pain?
• How often do you have pain?
• What does the facility do to manage your pain (e.g. hot or cold packs, pain medications)?
• Were you involved in the management of your pain?
• Is your pain relieved?
• For opioid use: What did the facility try before starting that medication?
• Does the pain prevent you from attending activities or doing other things you would like to do?
• Do you receive pain medications when needed such as before therapy or treatment?
• Do you receive pain medications in a timely manner when requested?
• Do you have any side effects (e.g., constipation or dizziness) related to your pain medications and are they addressed?

For newly admitted residents surveyors will determine if the facility developed and implemented a baseline care plan within 48 hours of admission that included the minimum healthcare information necessary to properly care for the immediate needs of the resident.

Additional regulatory guidance can be found in the State Operations Manual Appendix PP and the survey resources can be found on the CMS Nursing Home webpage and under the downloads section on this CMS webpage.

LeadingAge continues to develop webinars and resources on the updated requirements of participation which will be located on the LeadingAge learning hub. LeadingAge also continues to add QuickCasts on the regulatory groups.  Updated resources have also been added on the Nursing Home RoP Tools and Resources webpage. 

For more information about the updated requirements of participation and citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the September 13 call at 11:00AM. LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you would like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org.