Review of Frequently Cited F-tags June 2021

Regulation | July 27, 2021 | by Janine Finck-Boyle

LeadingAge reviews the most frequently cited federal tags on health inspection and complaint surveys across the country in June 2021. 

LeadingAge has heard from members on two different paths of nursing home surveys. Some members report an increasing number of surveys and other members report they are way overdue for an annual survey. Remember, as annual surveys came back on line, state health agencies are still surveying for infection control focused surveys, complaint surveys as well as recertification and any immediate jeopardy situation. This is a fluid situation and different in each state but brought an opportunity to analyze citations for the month of June in all CMS Regions.

Complaint surveys have frequently citations that almost mirror annual health surveys. From the analysis the following are the top five F-Tags cited:

F 880 Infection Prevention and Control

F 689 Free of Accidents, Hazards and Supervision

F 684 Quality of Care

F 677 ADL for Dependent Residents

F 580 Notify of Changes

Drilling down on the complaint survey frequently cited F-Tags, many of the same findings are being reported. As a complaint is investigated, a surveyor may cite any other deficient practice they see or review while surveying. LeadingAge has seen multiple tags being cited during a complaint survey. A complaint might be regarding care of a resident and as the surveyor begins the investigation, it is noticed that the ADLs for the resident were not documented as from the care plan or the notification of an incident was not relayed to the physician. Nursing homes should take time to review the intent of the F-Tag and the surveyor guidance to help compliance.

LeadingAge has analyzed the annual health survey frequently cited deficiencies in the past months, and most of the F-Tags still are the same in the top 10. However, there are a few F-Tags that are creeping up into the bottom of the top 10 and circling the next 10. Those F-Tags are the following:

F 761 Label/Storage Drugs – Biologicals

F 550 Resident Rights

F 755 Pharmacy Services/Pharmacy Records

F 600 Free from Abuse and Neglect

F 609 Reporting of Alleged Violations

Drilling down on these tags, LeadingAge found citations on not labeling eye drops and other medications with the information needed to ensure there was not a medication error. There was training missing on annual resident rights and staff performing duties that conflicted resident rights. Remember as nursing homes are opening to visitors, resident rights need to be reviewed with all staff. Take the time to go over annual in-services and review policies and procedures including alleged abuse reporting and investigations. F600 and F609 both are F-Tags that a nursing home could receive for not following an abuse allegation and investigation policy for reporting, timing and follow up. Lastly, as consultants are back in our nursing homes – pharmacy consultants and the medication carts could be an area of non-compliance. Ensure your consultant pharmacy is meeting the contract specifications and well as medication cart review and providing reports on time and working with either drug utilization committee, QAPI and/or antibiotic stewardship programs. F-Tags are easily cross tagged in a few of the frequently cited ones.