CMS made changes to §483.90(g)(1)‐(2) Resident Call System. The regulation states the facility must be adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area from each resident’s bedside and toilet and bathing facilities.

The guidance outlines that the call system must be accessible to residents while in their bed or other sleeping accommodations within the resident’s room. In addition, the call system must be accessible to the resident at each toilet, bath, or shower and should be accessible to a resident lying on the floor.

Action for Facilities:  

• Develop a process to routinely ensure the call system for residents is operational.
• Review the process to ensure that during a loss of power, the resident call system will be operational or ensure there is an alternate means of communicating with the staff in place.
• Examine the functionality of the call system to ensure it is accessible to a resident lying on the floor.

Detailed information can be found in the Appendix PP-State Operations Manual.

CMS has revised the §483.45-Pharmacy Services guidance. Changes include the following:

• F755-Pharmacy Services: CMS provided clarification language related to the disposal of Fentanyl patches.
• F757-Drug Regimen is Free from Unnecessary Drugs: CMS added language related to antibiotic stewardship and F881.
• F758-Free from Unnecessary Psychotropic Medications/PRN Use: CMS provided clarification of other classes of drugs not listed in the regulation and how they are affected by the psychotropic medication requirements. CMS also added language on potential misdiagnoses, such as schizophrenia, in order to prescribe antipsychotics.

Detailed information can be found in the Appendix PP-State Operations Manual.

Under §483.85, facilities must have a comprehensive Compliance and Ethics (C&E) program meeting all requirements laid out by CMS. Surveyors will be reviewing the facilities’ written policies and procedures and interviewing both staff and high-level personnel overseeing the program to determine if this program is in place. They will look for examples of the compliance program in action, evidence of the annual review, and that the organization has completed due diligence on the high level personnel overseeing the program.