What to Expect During a State Survey for Nursing Homes

As a nursing home administrator, you know that state surveys can be stressful. 

The unannounced nature of these inspections can create anxiety, but they are an important part of providing quality care for nursing home residents.

Understanding what to expect can help you face state surveys with confidence. Proper preparation also increases the chances of passing inspections.

In this article, we'll discuss the typical state survey process and the common aspects covered to help you prepare.

The Nursing Home Survey Process

The nursing home survey process is designed to check if facilities meet federal regulations and comply with state laws governing resident care and safety.

Surveyors, usually from the state health department, arrive unannounced and assess previous survey results and complaint investigations.

The survey team determines your nursing home's performance in different areas. This includes observing staff interactions with residents, checking medical records, inspecting the facility, and identifying risks to resident health.

Surveyors also interview residents and family members to gather feedback on the quality of care provided by your nursing home.

If your facility participates in Medicare and Medicaid programs, the Centers for Medicare & Medicaid Services (CMS) conducts an annual survey to determine if you meet the strict standards set by the federal government. 

The CMS surveyor also inspects if your nursing home has Medicaid and Medicare certifications. These prove that you can provide the best care to residents.

6 Key Areas Covered in a State Survey for Nursing Homes

Below are the six common areas that state surveyors focus on:

1. Quality of Care and Services

Surveyors evaluate how well your facility meets the regulatory requirements for resident care.

They review the care plans your nursing home staff provides to residents and verify if they align with professional standards of practice.

They also check if your facility organizes activities that can improve physical, mental, and psychosocial well-being.

2. Resident Rights

Surveyors also observe whether residents are treated with dignity and respect.

They’ll ask a family member or residents themselves about their experiences to make sure that your nursing facility values their autonomy and preferences.

3. Medication Management

During a state survey, inspectors check medication records to see if they are accurate and up-to-date.

Surveyors also assess whether your staff follows all federal laws and best practices for administering medications safely.

They even check the storage areas where you keep medicines to make sure they meet regulatory requirements.

4. Kitchen and Food Services

Surveyors inspect the kitchen, food storage, and meal preparation areas to see if your nursing home follows safety and health standards. They typically use quality inspection software to simplify the process and maintain accuracy.

They may also ask for a copy of your meal plans to confirm if residents receive nutritious meals that support their well-being.

5. Safety and Emergency Preparedness

Guaranteeing your facility's safety is another priority of a state survey.

Surveyors check for compliance with state and federal regulations on fire safety, evacuation plans, and other emergency preparedness protocols, such as the Life Safety Code.

When your nursing home complies with these regulatory requirements, you can protect both residents and employees during crises.

6. Infection Prevention

Lastly, surveyors assess your facility's infection control measures.

They observe your staff members if they follow strict protocols that minimize the spread of illness. This usually involves wearing personal protective equipment (PPE), disposing of waste in the proper area, and following appropriate hand hygiene practices.

Common Deficiencies Found in State Surveys for Nursing Facilities

After reviewing the key areas of focus, it’s important to understand where many nursing homes struggle during inspections.

The following deficiencies usually appear on the survey report and can either be declared as immediate jeopardy or actual harm.

• Inadequate staffing levels: Having insufficient staff can result in delayed or incomplete care for residents. This leads to potential health and safety issues.
• Incomplete or inaccurate medical records: Poor documentation can result in improper treatment, missed medications, or legal concerns.
• Lapses in medication management: Errors in administering or documenting medications can lead to serious health complications for residents.
• Neglecting resident rights: Failing to uphold resident autonomy, whether by limiting daily choices or not addressing grievances, can result in citations for disrespecting residents’ dignity and preferences.
• Failure to follow infection control protocols: Without consistent infection prevention measures, your nursing home is at a higher risk of outbreaks. You can put residents, staff, and your facility's reputation in danger.
• Non-compliance with safety regulations: Outdated fire safety plans, the lack of emergency drills, or inadequate evacuation procedures can leave residents and employees at risk during crises.

How to Prevent Deficiencies in a Nursing Home Survey?

If not addressed promptly, deficiencies can lead to penalties or, worse, the revocation of your nursing home license.

To avoid these consequences, you should prevent shortcomings by implementing the following:

• Maintain proper staffing levels: Nursing home regulations require a minimum staff-to-resident ratio. Make sure to meet this requirement to provide the necessary care for residents.
• Keep detailed, up-to-date records: You should regularly review medical records to confirm if they are accurate and updated. Then, make sure to store care plans and other important documents in a secure and accessible place.
• Conduct regular internal audits: Schedule frequent internal reviews of care, records, and safety protocols to identify issues before the survey team arrives at your nursing home.
• Provide ongoing staff training: Train your nursing home staff on the latest laws and best practices for infection control, medication management, and resident rights.
• Hold mock surveys: Conduct surprise mock inspections to simulate the state survey experience and identify any areas for improvement. This makes your employees ready for the real survey.
• Use inspection software: You can invest in a digital inspection management platform to identify issues, assign corrective actions, receive reminders, generate reports, and create survey readiness checklists.

Prepare For a State Survey with MyFieldAudits

MyFieldAudits helps your nursing home prepare for unexpected state surveys. They are an integrated partner solution that develops inspection programs and configures the software for their clients.

MyFieldAudits provides nursing homes with an advanced platform and expert team to conduct thorough inspections with ease.

MyFieldAudits stands out because they also provide training on their software and monitor usage compliance, empowering clients to focus on what they do best.

Schedule a demo today to get started! Need more information? Contact MyFieldAudits by dialing (844) 344-7265.

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FAQs About State Survey for Nursing Homes

What is a survey in a nursing home?

A survey in a nursing home is a formal evaluation by state or federal agencies to assess compliance with health, safety, and quality standards.

What is a CMS state survey?

The Centers for Medicare & Medicaid Services conducts a CMS survey to check if nursing homes comply with federal regulations and provide quality care.

What is the biggest complaint in nursing homes?

The common complaint in nursing homes is often about inadequate staffing. This can lead to delays in care and unmet resident needs.

What are the different types of state surveys for nursing homes?

Nursing homes face different types of surveys, such as routine, follow-up, and complaint-based surveys.

A routine survey happens annually, whereas a follow-up survey occurs after surveyors find deficiencies in your nursing facility. Meanwhile, a complaint investigation looks at the specific issues raised by residents or their family members.

The survey team may revoke licenses and enforce temporary management until you resolve the problems or deficiencies stated.

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