Clinical Surveillance Resources

When it comes to resident care, your role is to see the bigger picture and to put systems in place that not only protect your residents but also promote their best possible function. Preventing and identifying medical errors and adverse events is imperative for facility leaders. Using the latest technologies to synthesize resident care outcome data -- in complement with implementing proper bedside and clinical decision-making protocols -- are part of a strong clinical surveillance system that bolsters quality assurance. Find out what you need to know and how your facility can take evidence-based steps to improve care. 

  • KAER Toolkit: 4-Step Process to Detecting Cognitive Impairment and Earlier Diagnosis of Dementia (1/19)

    By National Nursing Home Quality Improvement Campaign - January 15, 2019
    KAER Toolkit: 4-Step Process to Detecting Cognitive Impairment and Earlier Diagnosis of Dementia from the GSA Workgroup on Cognitive Impairment Detection and Earlier Diagnosis. The KAER toolkit provides an extensive collection of evidence-based, practical and easy-to-use guidance for primary care providers, including clinically-relevant and scientifically supported measurement instruments for detecting cognitive impairment and links to clinical practice guidelines for conducting diagnostic evaluations for dementia.
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  • CMPRP Nursing Home Staff Competency Assessment Toolkit - New UPDATE (1/19)

    By CMS - January 14, 2019

    UPDATE 1/08/19: The electronic versions of the Nurse and Management Assessment have been updated.

    Toolkit 1: Nursing Home Staff Competency Assessment

    Quality care is complex. That’s why the CMPRP competency assessment helps nursing homes break down and self-examine some of the most important building blocks of quality care. Use the competency assessment to identify areas where your nursing home is doing well, versus where your facility might need support. Once you know where you need support, CMPRP can provide funding, technical assistance and learning opportunities to help address some of your facility’s toughest challenges, in order to offer the best possible care to your residents.

    There are three competency assessments in print and electronic formats:

    1) Certified Nursing Assistants (CNA)/Certified Medication Technicians (CMT)

    2)Licensed Practical/Vocational Nurses (LVN/LPN) and Registered Nurses (RN)

    3) Assistant directors of nursing (ADON), directors of nursing (DON) and administrators.

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  • Register for March 12 Dementia Care & Psychotropic Medication Tracking Tool Call (1/19)

    By CMS - January 13, 2019
    During this call, gain insight on the Dementia Care & Psychotropic Medication Tracking Tool, a free, publicly available electronic tool that facilitates a structured approach to tracking preference-based care and psychotropic medication use among residents living with dementia. Also, learn about a recently released Nursing Home Staff Competency Assessment toolkit. Additionally, CMS provides updates on the Phase 3 Requirements for Participation from the Reform of Requirements for Long-Term Care Facilities final rule and the progress of the National Partnership to Improve Dementia Care in Nursing Homes. A question and answer session follows the presentations.
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  • Register for Free Jan. 24 QIN-QIO Webinar: All Cause Harm Prevention in Nursing Homes Applying Strategies from the New CMS Change Package (1/19)

    By QIN-QIOs - January 03, 2019
    One-third of SNF residents experience an adverse or temporary harm event, and the majority of those are preventable. As part of CMS’s focus on raising awareness of nursing home safety and to support safer nursing home care across the nation, CMS and the Quality Innovation Network National Coordinating Center released a new resource: a Change Package to prevent all cause harm in nursing homes. The Change Package is a compendium of successful practices of high-performing nursing homes, illustrating how they prevent harm while honoring each resident’s rights and preferences. 

    Please join us to learn more about the development of the Change Package and how you can use it to improve the quality of life and quality of care for those living in nursing homes and other long-term care settings. Registration is required
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  • CDC Pneumococcal Vaccination App: PneumoRecs VaxAdvisor (1/19)

    By CDC - January 03, 2019
    CDC launched an app to help vaccination providers quickly and easily determine which pneumococcal vaccines a patient needs and when.
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  • National Partnership to Improve Dementia Care in Nursing Homes: Antipsychotic Medication Use Data Report (1/19)

    By CMS - January 03, 2019

    The National Partnership to Improve Dementia Care in Nursing Homes is committed to improving the quality of care for individuals with dementia living in nursing homes. The National Partnership has a mission to deliver health care that is person-centered, comprehensive and interdisciplinary with a specific focus on protecting residents from being prescribed antipsychotic medications unless there is a valid, clinical indication and a systematic process to evaluate each individual’s need. The Centers for Medicare & Medicaid Services (CMS) promotes a multidimensional approach that includes; research, partnerships and state-based coalitions, revised surveyor guidance, training for providers and surveyors and public reporting. 

    CMS is tracking the progress of the National Partnership by reviewing publicly reported measures. The official measure of the Partnership is the percentage of long-stay nursing home residents who are receiving an antipsychotic medication, excluding those residents diagnosed with schizophrenia, Huntington's Disease or Tourette’s Syndrome. In 2011Q4, 23.9 percent of long-stay nursing home residents were receiving an antipsychotic medication; since then there has been a decrease of 38.9 percent to a national prevalence of 14.6 percent in 2018Q2. Success has varied by state and CMS region, with some states and regions having seen a reduction of greater than 40 percent. 

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  • Food Safety and Holiday Treats: 6 Ways to Shore Up Visitor Food Policy Implementation

    By Jessica Kunkler, MA, Staff Writer - December 18, 2018

    During the holidays, SNF staff across the country welcome an increased number of visitors with special treats to share with loved ones. While extra visitors and sweet treats add to the spirit of the facility at holiday times, they can also pose safety risks to residents. (Consider a yummy pumpkin roll with cream cheese frosting, left at room temperature for 48 hours in a resident’s room.) If you haven’t already done so, now is a good time to shore up your facility’s visitor food policy implementation. Here’s how:

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  • FY 2021 SNF QRP Program Data Collection & Final Submission Deadlines (12/18)

    By CMS - December 18, 2018

    Skilled Nursing Facility Quality Reporting Program Data Collection & Final Submission Deadlines for the FY 2021 SNF QRP


    This table provides the data collection time frames and final submission deadlines for the Fiscal Year (FY) 2021 Skilled Nursing Facility Quality Reporting Program (SNF QRP). The first column displays the measure name, the second column displays the data collection time frame, and the third column displays the final data submission deadlines.

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  • NNHQIC All-Cause Harm Prevention in Nursing Homes Change Package (12/18)

    By National Nursing Home Quality Improvement Campaign - December 07, 2018

    Change Package to prevent harm related to medication adverse events, other adverse events, infection, and abuse,and neglect for nursing home residents.


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  • Nursing Home Compare Claims-based Measures Technical Specifications Plus Appendix Updated (12/18)

    By CMS - December 07, 2018

    Nursing Home Compare Claims-based Measures Technical Specifications -Update December 2018  plus Appendix

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  • Some States Urge Providers to Check Freezers Due to National Ground Beef Recall (12/18)

    By USDA - December 06, 2018

    Some states, including Texas, have urged nursing homes to check their freezers for ground beef that may be recalled in this Class ! recall, meaning the beef should not be consumed.

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  • Taking a Person-Centered Approach to Drug Regimen Review

    By Linda Shell, DNP, MA, RN, DNS-CT - December 03, 2018

    Nurses are critical to the health and well-being of residents in long-term care, overseeing all aspects of care, including residents’ physical, mental, social, and spiritual wellness. Although members of the interdisciplinary team (IDT) assist with their respective disciplines, the nurse is ultimately the one with 24/7 oversight of resident care. Nurses are the eyes and ears of the physician in the long-term care setting and serve as advocates for the residents during the drug regimen review (DRR).

    Since the most recently updated CMS guidelines regarding DRR which includes medication reconciliation in the skilled nursing facility were released, facilities have struggled to understand the rules. One of the significant drivers behind these new regulations is the increased rate of medication-related adverse drug events (ADEs). One critical item, however, is still missing from the updated requirements—the resident perspective on medications. The CMS guidelines address DRR and identify the medications that must be reviewed, the scheduling of reviews, clinically significant medication issues, the facility-designated person responsible for conducting the DRR, and communication between the physician and nurse. Little to no mention is made of resident preference and choice related to medications. Do residents want to take all those medications? Is their quality of life improving?

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  • NNHQIC Sets Dementia Care & Psychotropic Medications Goal (11/18)

    By NNHQIC - November 26, 2018

    The National Nursing Home Quality Improvement Campaign's new quality goal to improve care for individuals living with dementia focuses on knowing the person, building on strengths, filling days with positive moments, and proactively addressing unmet needs.

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  • CMS Offers Networking, Technical Assistance, Funding as Part of CMP Reinvestment Project (11/18)

    By CMS - November 26, 2018

    Breakthrough Communities and Technical Assistance

     A Breakthrough Community is a voluntary and customized health care improvement program that is based on a model designed by the Institute for Healthcare Improvement (IHI). Its goal is to achieve “breakthrough” improvement in nursing homes that may be experiencing challenges in one of two program areas: reducing adverse events and/or improving dementia care.

    In Breakthrough Communities, nursing homes work with their peers to test interventions that will lead to improvement in quality of life and quality of care for residents of nursing homes.

    If you are interested and want to apply, please email

    Technical Assistance To improve dementia care, CMS funds and provides one-to-one Technical Assistance (TA) to a selection of nursing homes through the CMPRP. One-to-one TA will be customized to your nursing home to address unique barriers in improving quality of life and quality of care for residents with dementia.

    The purpose of one-to-one TA is to provide education and support to nursing homes’ quality improvement processes, including root cause analysis and the development of a performance improvement plan framework for the improvement of dementia care and ensuring the appropriate use of antipsychotic medications.

    If you are interested and want to apply, please email

    Civil Money Penalty (CMP) Funds

    About Civil Money Penalty (CMP) Funds

    A CMP is a monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against nursing homes for either the number of days or for each instance a nursing home is not in substantial compliance with one or more Medicare and Medicaid participation requirements for long-term care facilities.

    A portion of CMPs collected from nursing homes are returned to the states in which CMPs are imposed. State CMP funds may be reinvested to support activities that benefit nursing home residents and that protect or improve their quality of care or quality of life.

    What CMP Funds Can Be Used For

    CMP funds may be used for (but not limited to) the following:

    ·        Assistance to support and protect residents of a facility that closes or is decertified

    ·        Time-limited expenses incurred in the process of relocating residents to home and community-based settings or another facility when a facility is closed or downsized pursuant to an agreement with the state Medicaid agency

    ·        Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities

    Facility improvement initiatives, such as joint training of facility staff and surveyors, or technical assistance for facilities implementing quality assurance and performance improvement programs

    How to Apply for CMP Funds

    The application process for CMP funds is determined by the state in which the nursing home is located. The process for each state may differ therefore states have their own applications for CMP funds and applicants should use their state specific application and instructions.

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  • Infection Prevention and Control Audits: Start with Hand Hygiene

    By Caralyn Davis, Staff Writer - November 26, 2018

    Nursing homes can have the most beautiful policies and procedures for infection prevention and control in the world, but if staff aren’t following through on them, they are a waste of paper, notes Deb Patterson Burdsall, PhD, RN-BC, CIC, FAPIC, an infection prevention and control consultant and faculty member at the Association for Professionals in Infection Control and Epidemiology (APIC) in Arlington, VA.


    “So monitoring and auditing infection prevention processes in the facility is a critical component of quality care,” says Burdsall. “Unfortunately, the focus on infection prevention has not always been well-supported because infection surveillance, monitoring whether proper supplies are available and used correctly, and watching whether staff are performing hand hygiene and correctly using personal protective equipment all take time, which means the effort costs money.”

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