CMS Federal Surveyors Focus Areas

Posted on February 26, 2019 by Sue Boyd

The Centers for Medicare & Medicaid Services (CMS) recently announced they are piloting a new Federal Monitoring Survey to replace the existing FOSS/FOQIS surveys. Under this pilot, federal oversight of surveys done by state agencies will be conducted primarily in three ways: 

• Resource and Support Surveys
• Focused concern surveys
• Full comparative surveys

Resource and Support Surveys is a process where a federal surveyor accompanies a state team on-site and engages in an on-going dialogue with members of the state survey team to ensure that all areas of concern are investigated thoroughly and according to CMS’s survey protocols. The federal surveyor is intended to be a resource to the state team during the process.

During the Resource and Support Survey the Federal surveyor will have specific areas of concern that he or she will be focusing on during the survey. The concern focused areas for FY19 include federal, regional, and state specific areas to be targeted during CMS oversight surveys. 

Abuse (national focus)

Sufficient and competent staffing (national focus)

Unnecessary medications – psychotropics (regional focus)

Activities (Minnesota focus)

The Federal surveyor will accompany the state surveyor investigating these specific areas and will make observations of care. Provide support during interviews of facility staff and review relevant records. The Federal surveyor and the state surveyor should discuss findings as necessary related to these areas of concern. This survey is will provide feedback to the state surveyors on improvement areas.

CMS will be conducting Focused Concern Surveys in conjunction with the resource and support surveys. Resource and Support surveys will be conducted during the first half of each fiscal year.  During the second half of the fiscal year, the resource and support surveys will be replaced with focused concern surveys.

A focused concern survey will be conducted within 30 to 60 days of a survey conducted by the state surveyors but will only look at those specific areas of concern identified in the Resource and Support surveys.  The findings specific to these areas of concern will then be compared with the state survey results to determine if all areas were investigated thoroughly and appropriate compliance decisions were made.

The Comparative Survey process by CMS Federal surveyors will remain unchanged. CMS will conduct a full comparative survey within 30 to 60 days following a state survey and the findings of the CMS survey will be compared with the findings of the state.

Don’t be surprised if the focus areas have a heightened focus on your next annual survey or oversight survey.