State surveys are back, and a review of the top F-Tags as of April 2021 suggests that issues related to the COVID-19 pandemic are still hot, topping the list of most commonly cited F-Tags. Important to note for assisted living and other residential care settings, surveyors often look to higher-acuity regulations and guidance to direct their focus and decision-making.

LeadingAge analyzed the top F-Tags in March, reporting the most deficiencies related to:

• Reporting – National Health Safety Network (F-884);
• Infection Prevention & Control (F-880);
• COVID-19 Testing – Residents & Staff (F-886);
• Free of Accident Hazards/Supervision/Devices (F-689); and
• Quality of Care (F-684).

In addition to these top five, the most commonly cited F-Tags in both March and April include:

• Free of Accident Hazards/Supervision/Devices (F-689);
• Notify of Changes (Injury/Decline/Room, etc) (F-580);
• Influenza and Pneumococcal Immunizations (F-883);
• Reporting – Residents, Representatives & Families (F-885);
• Treatment/Services to Prevent/Heal Pressure Ulcers (F-686);
• Food Procurement, Store/Prepare/Server Sanitary (F-812);
• ADL Care Provided for Dependent Residents (F-677);
• Develop/Implement Comprehensive Care Plan (F-656);
• Label/Store Drugs and Biologicals (F-761); and
• Reporting of Alleged Violations (F-609).

According to the LeadingAge analysis, these represent some significant changes from earlier analyses, as well as deficiencies commonly seen in past reports. For instance, an Office of the Inspector General (OIG) report analyzed nursing home deficiencies cited between 2013-2017. While Free of Accident Hazards/Supervision/Devices (F-689) and Infection Prevention & Control (F-880) did make the top five, that list was rounded out by Provide Care and Services for Highest Well-Being (multiple tags), Food Procurement, Store/Prepare/Serve – Sanitary (F-812), and Develop Comprehensive Care Plans (F-656).

LeadingAge offered guidance on how to ensure compliance on these issues. For instance, for Infection Prevention & Control (F-880), they suggest reviewing staff in-services and training, and ensuring team members can demonstrate infection control procedures. Another recommendation is to state to a surveyor how your organization is following practices for hand hygiene and donning/doffing PPE. Finally, review and document your monitoring and practices around preventing infection spread, listing key tools used by the infection preventionist.

In honor of National Skilled Nursing Care Week, we’re providing a free tip sheet on survey compliance. To download a copy of  Tips for Ensuring Compliance with Commonly Cited F-Tags click here.