Survey Smart: Preventing the Most Frequently Cited Deficiencies in SNF
Here are the Top 5 Deficiencies Cited in Nursing Homes (based on CMS data and common trends) along with practical tips on how to avoid them::
1. F-Tag 880 – Infection Prevention and Control
Description: Failure to prevent, identify, and control infections, including improper use of PPE, hand hygiene, or isolation procedures.
How to Avoid:
Maintain a robust Infection Prevention and Control Program (IPCP).
Assign a trained Infection Preventionist (IP).
Conduct routine staff training and hand hygiene audits.
Ensure proper PPE usage, disinfection protocols, and isolation procedures.
Stay current with CDC and CMS guidance on COVID-19 and other communicable diseases.
2. F-Tag 684 – Quality of Care
Description: Residents must receive the necessary care and services to attain or maintain their highest practicable physical, mental, and psychosocial well-being.
How to Avoid:
Conduct comprehensive assessments and update care plans regularly.
Ensure timely interventions for changes in condition.
Monitor for pressure ulcers, falls, weight loss, and infections.
Implement interdisciplinary team reviews and QAPI follow-ups.
3. F-Tag 689 – Free of Accident Hazards/Supervision/Devices
Description: Failure to provide adequate supervision or assistive devices to prevent accidents and injuries, such as falls or elopements.
How to Avoid:
Perform fall risk assessments and implement individualized safety plans.
Maintain proper staffing levels and ensure frequent rounding.
Inspect and maintain equipment, handrails, call lights, and floors.
Use alarms, wander guards, and door monitors appropriately.
4. F-Tag 677 – ADL Care for Dependent Residents
Description: Failure to provide appropriate assistance with Activities of Daily Living (ADLs), like bathing, grooming, dressing, eating, and toileting.
How to Avoid:
Document ADL needs and interventions clearly in care plans.
Assign consistent caregivers to residents when possible.
Train staff to respect resident dignity and autonomy.
Conduct routine audits of ADL care and resident satisfaction.
5. F-Tag 656 – Comprehensive Care Plans
Description: Incomplete or outdated care plans that do not reflect residents’ needs, preferences, and goals.
How to Avoid:
Complete care plans within 7 days of MDS completion and review at least quarterly.
Involve the resident, family, and interdisciplinary team in planning.
Ensure care plans are person-centered, specific, and actionable.
Conduct regular audits for accuracy and relevance.
Bonus Tip:
Implement a strong Quality Assurance and Performance Improvement (QAPI) program to track, monitor, and prevent these deficiencies continuously. Regular internal audits and staff education are key to maintaining compliance.
Preventing survey deficiencies isn’t just about checking boxes—it’s about building a culture of accountability, consistency, and resident-centered care. By staying informed about common pitfalls and implementing proactive, team-based strategies, your facility can not only avoid costly citations but also elevate the quality of care you provide every day. Stay survey smart, invest in staff education, and keep your focus where it matters most: the well-being and dignity of your residents.