Fortress Risk Management Suite
Survey Pathways
Investigate and document deficiencies using structured pathways
41 results found
Abuse Critical Element Pathway
Form CMS-20059 - Investigate alleged violations of abuse including observations, interviews, record reviews, and critical element decisions
Accidents Critical Element Pathway
Form CMS 20127 - Review supervision, assistive devices, accident prevention including falls, smoking safety, elopement, resident altercations, substance use disorder, entrapment risks, and environmental hazards
Activities Critical Element Pathway
Form CMS-20065 - Comprehensive activities review covering program design, resident assessment, care planning, and activity implementation
Activities of Daily Living (ADL) Critical Element Pathway
Form CMS-20066 - Comprehensive ADL review covering hygiene, elimination, dining, and communication to determine if facility practices maintain, improve, or prevent avoidable decline in ADLs
Behavioral and Emotional Status Critical Element Pathway
Form CMS-20067 - Determine if facility provides necessary behavioral, mental, and emotional health care and services, implementing person-centered, non-pharmacological approaches
Bladder or Bowel Incontinence Critical Element Pathway
Form CMS 20125 - Review continence care, toileting programs, UTI prevention, environmental accommodations, and interventions to maintain/restore continence
Communication and Sensory Problems Critical Element Pathway
Form CMS-20069 - Review communication abilities, vision and hearing needs, assistive devices, and environmental accommodations
Death Critical Element Pathway
Form CMS-20074 - Investigate circumstances surrounding death of resident not receiving end of life care to determine if facility identified, assessed, and intervened appropriately
Dementia Care Critical Element Pathway
Form CMS 20133 - Assess and treat residents with dementia using person-centered, non-pharmacological approaches, ensuring highest practicable well-being
Dental Status and Services Critical Element Pathway
Form CMS-20070 - Review oral/dental health, denture care, routine and emergency dental services, and dental care planning
Dialysis Critical Element Pathway
Form CMS-20071 - Review hemodialysis, home hemodialysis, and peritoneal dialysis care including infection control, monitoring, and coordination with dialysis facilities
Dining Observation
Form CMS-20053 - Comprehensive dining observation covering meal services, dignity, environment, and nutrition
Discharge Critical Element Pathway
Form CMS-20132 - Evaluate compliance with discharge rights and requirements, proper notice, discharge planning, and post-discharge care coordination
Environmental Observations
Form CMS-20061 - Review environmental concerns including accommodation of needs, call systems, temperature, lighting, cleanliness, equipment condition, pest control
Extended Survey
Form CMS-20091 - Comprehensive review conducted when Substandard Quality of Care (SQC) is verified, investigating systemic failures in staffing, training, policies, and administration
General Critical Element Pathway
Form CMS-20072 - Investigate quality of care concerns not covered by other specific pathways
Hospice and End of Life Care Critical Element Pathway
Form CMS-20073 - Review end of life care, palliative care, comfort care, or hospice care from Medicare-certified hospice
Hospitalization Critical Element Pathway
Form CMS 20123 - Investigate hospitalizations to determine if facility identified changes in condition, intervened appropriately, and complied with transfer/discharge requirements
Hydration Critical Element Pathway
Form CMS 20092 - Review residents at risk for or who have experienced dehydration, covering fluid intake monitoring, assistance, interventions, and care planning
Infection Prevention, Control & Immunizations
Form CMS-20054 - Comprehensive infection control review covering standard precautions, IPCP, surveillance, and immunizations
Kitchen/Food Service Observation
Form CMS-20055 - Complete kitchen inspection covering food storage, preparation, service, sanitation, and dietary staff
Medication Administration Observation
Form CMS-20056 - Observe medication administration across all routes, minimum 25 opportunities, calculate error rates
Medication Storage and Labeling
Form CMS-20089 - Review medication storage rooms and carts for proper security, temperature control, labeling, controlled substance management, and disposal procedures
Neglect Critical Element Pathway
Form CMS 20130 - Investigate alleged neglect involving structure/process failures, systemic care delivery issues, staffing deficiencies, and staff training requirements
Nutrition Critical Element Pathway
Form CMS-20075 - Review resident not maintaining acceptable nutritional status or at risk for impaired nutrition
Pain Recognition and Management Critical Element Pathway
Form CMS-20076 - Review pain assessment, management, and monitoring to support highest practicable well-being
Personal Funds Review
Form CMS-20063 - Review personal funds management including access, quarterly statements, costs disclosure, separate accounting, interest payments, and surety bond
Physical Restraints Critical Element Pathway
Form CMS-20077 - Investigate use of physical restraints, devices, or practices that restrict resident freedom of movement
Positioning, Mobility & Range of Motion (ROM) Critical Element Pathway
Form CMS 20120 - Review ROM, mobility, and positioning concerns including exercises, assistive devices, contracture care, and therapy services
Preadmission Screening and Resident Review (PASARR) Critical Element Pathway
Form CMS-20090 - Review Level I pre-screening and Level II referrals for residents with mental disorders, intellectual disabilities, or related conditions
Pressure Ulcer/Injury Critical Element Pathway
Form CMS 20078 - Review pressure ulcer prevention, treatment, wound care practices, infection control, and healing interventions
QAPI and QAA Review
Form CMS-20058 - End-of-survey review of Quality Assurance & Performance Improvement program, QAA Committee activities, systemic issue identification and corrective actions
Resident Assessment Critical Element Pathway
Form CMS 20131 - Review MDS accuracy, completion, submission, certification, and adherence to RAI guidelines when assessment concerns are identified
Resident Council Interview
Form CMS-20057 - Interview active members of the Resident Council covering council operations, grievances, resident rights, and facility responsiveness
Respiratory Care Critical Element Pathway
Form CMS 20081 - Review respiratory care services including oxygen therapy, breathing exercises, sleep apnea, nebulizers/inhalers, tracheostomy, and ventilator care
SNF Beneficiary Notification Review
Form CMS-20052 - Evaluate compliance with Medicare Part A beneficiary notification requirements (SNF ABN and NOMNC)
Specialized Rehabilitative or Restorative Services Critical Element Pathway
Form CMS-20080 - Review provision of specialized rehabilitative services (PT, OT, SLP) and restorative nursing programs to maintain, restore, or improve functional ability
Sufficient and Competent Nurse Staffing Review
Form CMS-20062 - Evaluate sufficient and competent nursing staff through PBJ review, observations, interviews, and record reviews
Tube Feeding Status Critical Element Pathway
Form CMS-20093 - Review tube feeding care covering insertion rationale, infection control, complications prevention, restoring eating skills, and care planning
Unnecessary Medications, Chemical Restraints & MRR Critical Element Pathway
Form CMS 20082 - Review medication regimen for unnecessary medications, psychotropic medications, chemical restraints, and medication regimen review process
Urinary Catheter or Urinary Tract Infection Critical Element Pathway
Form CMS 20068 - Review catheter care, UTI prevention and treatment, infection control practices, proper catheter management and resident education
What are Survey Pathways?
Survey Pathways are structured investigation tools that guide surveyors through the systematic review of compliance with specific regulatory requirements.
- • Step-by-step investigation guidance for each F-tag
- • Critical elements that must be reviewed
- • Interview questions and observation focus areas
- • Documentation requirements and record review checklists
- • Severity and scope determination criteria
- • Examples of compliant and non-compliant practices