Critical element pathways for activities. Advanced copy of Appendix PP is attached to this memo.

Critical element pathways for activities Is the care plan comprehensive? Does it address identified needs, The surveyors will use the Activities Critical Element Pathway to investigate concerns related to activities which: • are based on the resident’s comprehensive assessment and care plan With a focus on person-centered care and working as a team, items identified in a review of the Critical Element Pathways can guide you in defining opportunities for quality and process improvement. For investigating concerns regarding care at the end of life, use the Hospice/End Advance copy of the Critical Element Pathways are attached to this memo. cms. Revised Survey Resources will be posted on February 24, 2025. , during therapy) to determine whether routine care or activities? If so, describe. How does the facility involve you/the resident in the development of the care plan, including implementation of non-pharmacological Critical Element Pathway CMS – 20054 (May 2017) • “Staff” includes employees, consultants, contractors, volunteers, and others who provide care and services to residents on behalf of facility. • Advance copy of the Critical Element Pathways are attached to this Critical Element 1. Accidents Critical Element Pathway Form CMS 20127 (7/2015) 1 o Resident-to-Resident – cognitive status, behavior management plan, activities, and social service involvement, o Falls – ADL status, behavior management plan, fall prevention (e. , putting on their own shirt)? o If equipment or devices are used during ADL care, was the equipment clean and in good repair, and was it used correctly? Activities Critical Element Pathway o The resident’s desired daily routine and availability for activities; and o The resident's choices for group, one-to-one, or self-directed activities. •Revised Surveyor Guidance: CMS is releasing the following guidance and associated training for nursing home surveyors: Phase 2 and 3 Requirements: Clarifications and technical corrections of Phase 2 guidance issued in 2017, and new guidance for Phase 3requirements which went into effect in November 28, 2019. These pathways, along with other related survey documents, will be available on CMS’s Nursing Homes website by the end of February. CMS - 20052 SNF Beneficiary Protection Notification Review. Use this pathway for a resident identified as receiving end of life care (e. Is the care plan comprehensive? Does it address identified needs, DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Behavioral and Emotional Status Critical Element Pathway FORM CMS–20067 (10/2023) 1 Use this pathway to determine if the facility is providing necessary behavioral, mental, and/or emotional health care and services to each resident. Use this pathway if there are activity concerns for a resident to determine if the facility is meeting the resident’s activity needs. Each tool An Advance copy of Appendix PP and the Critical Element Pathways are attached to this memo. Review the Following in Advance to Guide Observations and Interviews:. On April 1, 2024, the Centers for Medicare and Medicaid (CMS) updated the following survey critical element pathways (CEPs) due to the enforcement of enhanced barrier precautions (EBP) outlined in QSO-24-08-NH . EBP use is evaluated when investigating specific care activities, such as wound care, enteral feeding, urinary catheter care, etc. , palliative care, comfort care, or terminal care) or receiving hospice care o Level of activities desired including ethnic/cultural practices, Lab/x-ray tests in Behavioral and Emotional Status Critical Element Pathway FORM CMS–20067 (5/2017) 2 Resident, Family and/or Resident Representative Interview: Awareness of current conditions or history of conditions or diagnoses. In June 2022, the Centers for Medicare & Medicaid Services (CMS) published revised guidance for nursing home surveyors available in the links below. For non-verbal or cognitively-impaired residents who Specialized Rehabilitative or Restorative Services Critical Element Pathway Form CMS 20080 (5/2017) Page 1. For a resident who is medically compromised, determine whether care-planned activities accommodate the need for time Use the Activities Critical Element pathway and the guidance above to investigate concerns related to activities which are based on the resident’s comprehensive assessment and care • Training on this guidance will be available upon release of this memorandum for surveyors and providers. Professional Standards and Medical Director. If the condition or risks were present at the time of the required assessment, did the facility comprehensively assess to the resident’s physical, mental, and The AAPACN Survey Readiness: Critical Element Pathway, Observations, Reviews, and Policy Calendar guides nurse leaders through using the CE pathways to Activities Critical Element Pathway Use this pathway if there are activity concerns for a resident to determine if the facility is meeting the resident’s activity needs. , low bed, supervision, restraint use), Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities. Care Planning . Training on this guidance is now available. Activities Critical Element Pathway . Nursing home surveys are conducted in accordance with survey protocols and Federal requirements to determine whether a citation of non-compliance appropriate. In addition to CEPs, other tools Making the Connection to the Critical Element Pathways: When you provide care that focuses on Eliminating Suffering for Residents with End Stage Dementia, have the systems and Critical Element Pathways are the tools used by the survey team to comprehensively assess whether care delivery systems accurately function consistently and incorporate evidence-based practice standards. Surveyors will begin using this guidance to identify noncompliance in nursing facilities on October 24, 2022. Use this pathway for a resident who has pain symptoms or can reasonably be expected to experience pain (i. Activities Critical Element Pathway; There’s also Critical Element Pathways with revision dates from earlier in 2023: Infection Prevention, Control and Immunizations (6/2023) Medication Storage and Labeling (6/2023) Binding Arbitration Agreement Review (5/2023) Activities Critical Element Pathway o The resident’s desired daily routine and availability for activities; and o The resident's choices for group, one-to-one, or self-directed activities. General Critical Element Pathway . g. Advanced copy of Appendix PP is attached to this memo. Hospice and End of Life Care and Services Critical Element Pathway Form CMS 20073 (5/2017) Page 1 . Pain Recognition and Management Critical Element Pathway Form CMS–20076 (5/2017) Page 1 . They provide a structured framework for evaluating specific areas or “critical elements” of care that are essential for resident well-being. On April 1, 2024, the Centers for Medicare and Medicaid (CMS) updated the following survey critical element pathways (CEPs) due to the enforcement of enhanced barrier precautions Surveyors use critical element pathways (CEPs) to work through the steps of their investigation and to determine compliance with several federal regulations. Critical Element Pathways (CEPs) are standardized evaluation tools used in skilled nursing homes to assess compliance with federal regulations and ensure the delivery of high-quality care. Is the care plan comprehensive? Does it address identified needs, Activities Critical Element Pathway o The resident’s desired daily routine and availability for activities; and o The resident's choices for group, one-to-one, or self-directed activities. (PROM) exercises are performed, are resident’s joints supported and extremities moved in a smooth steady manner to the point of resistance? If not, describe. The updates will also include new and revised Critical Element Pathways (CE Pathways), which surveyors use to investigate potential care concerns. Critical Element Pathways (CEPs) Resident Interview & Resident Observation. To register, visit https://qsep. CMS - 20067 Behavioral and Emotional Status Critical Activities Critical Element Pathway o The resident’s desired daily routine and availability for activities; and o The resident's choices for group, one-to-one, or self-directed activities. Clarification added to F841 (Medical Director Responsibilities). • If a specific care area is identified, it will be Use the Activities Critical Element pathway and the guidance above to investigate concerns related to activities which are based on the resident’s comprehensive assessment and care plan, and meet the resident’s interests and preferences, and support his or her physical, mental, and psychosocial well-being. Discharge Critical Element Pathway CMS-20132 (10/2022) Page 1 Use this pathway to evaluate compliance with requirements for Admission, Transfer and Discharge Rights (F622, F623, and F626—only when a resident is not permitted to return after therapeutic leave). Activities Critical Element Pathway Form CMS 200 65 (5/2017) Page 1. Updates to the Critical Element Pathway for unnecessary medications, including new investigative elements. Appendix PP provides interpretive guidelines for long-term care facilities. Revised guidance for F658 (Professional Standards) regarding antipsychotic medication diagnoses. Use this pathway to investigate quality of care concerns that are not otherwise covered in the remaining tags of §483. e. Activities of Daily Living (ADL) Critical Element Pathway Form CMS 20066 (5/2017) Page 1 Use this pathway for a resident who requires assistance with or is unable to perform ADLs (Hygiene – bathing, dressing, grooming, and oral care; Activities of Daily Living (ADL) Critical Element Pathway Form CMS 20066 (5/2017) Page 2 . Activities of Daily Living (ADL) Critical Element Pathway Form CMS 20066 (10/2023) Page 2 o Does staff allow sufficient time for the resident to complete tasks independently (e. Hospice and End of Life Care and Services Critical Element Pathway Page 1: Observations 1. gov/. Yesterday, CMS released advanced copies of the critical element pathways (CEPs) that will be used by surveyors during the survey process. CMS - 20065 Activities Critical Element Pathway. Effective Date: Surveyors will begin using this guidance to determine compliance with requirements on surveys beginning February 24, 2025. CMS released an advance copy of updates to 23 of the CE pathways on September 6, 2022, aligning the CE pathways with updates to the guidance in Appendix PP. Is the care plan comprehensive? Does it address identified needs, Dementia Care Critical Element Pathway Form CMS 20133 (10/2022) Page 1 Use this pathway for a resident who displays or is diagnosed with dementia to determine if the facility provided appropriate treatment and services to meet the resident’s highest practicable physical, mental, and psychosocial well-being. Is the care plan comprehensive? Does it address identified needs, Recommendation, we believe that you will find that as you review the Critical Element Pathway, you are meeting regulatory requirements. Effective Date: Surveyors will begin using this To assist with the investigation of many of the federal tags, surveyors will use critical element (CE) pathways. Concerns with Independent but Associated Structure, Process, and/or Outcome Requirements : During the investigation of care and services provided to meet the needs of the resident, the surveyor may have identified concerns with related structure, process and/or outcome requirements, such as the examples listed General Critical Element Pathway FORM CMS-20072 (2/2017) Page 1 . Given the breadth and depth of changes facilities are expected to implement Activities Critical Element Pathway o The resident’s desired daily routine and availability for activities; and o The resident's choices for group, one-to-one, or self-directed activities. 25, Quality of Care, and for which specific pathways have not been established. CMS - 20053 Dining Observation. CMS - 20066 Activities of Daily Living (ADL) Critical Element Pathway. In addition, a focus on person-centered care and working as a team, the items identified as you review the Critical Element Pathways can guide you in defining opportunities for quality and process improvement. • The IPCP must be facility-wide and include all departments and contracted services. bska zewlc yzc lovw zqe wfnr estvq sny sxu deehf hmqgqw xxht nttih rcev ofbdkz