CMS Issues Draft Guidance on Accidents/Supervision

VHCA (7/20/2007)

The Centers for Medicare and Medicaid Services (CMS) has released an advance copy of revised surveyor guidance for surveying Accidents and Supervision (Tag F323).  In the CMS memorandum to State Survey Agency Directors, CMS announced that the requirements will become effective on August 6, 2007.  At that time, a final copy of this new guidance will be available on the CMS website and ultimately will be incorporated into Appendix PP of the State Operations Manual.  The guidelines combine tags F323 and F324 into one tag, F323, accident prevention.  Therefore, surveyors will no longer use Tag F324 when surveying for compliance in the area of accidents and supervision. 

The advance copy of the Accidents and Supervision guidance includes interpretive guidelines, the investigative protocol, and determination of compliance.  The interpretive guidelines clarify areas such as resident supervision, hazard identification and resident risk, falls, unsafe wandering/elopement, environmental assessment of hazards, and resident-to-resident altercations.  The investigative protocol explains objectives and procedures surveyors will need for their investigation.  The deficiency categorization provides guidance for the determination of the correct level of severity of outcome to residents from deficiencies for Tag F323.  State agencies have received training materials for the revised Tag F323 to assure that all surveyors are trained in the revised guidance.