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Survey, Regulatory & Legal

Every skilled nursing center certified to provide care to Medicare and Medicaid beneficiaries must comply with the Federal Requirements of Participation. These requirements are contained in the Federal Regulations for Nursing Facilities, which also state each center must comply with all applicable Federal, State, and local laws, regulations, and codes with accepted professional standards.  

Here you will find helpful resources needed to understand and develop systems to meet requirements and regulations that fall under the Requirements of Participation, survey preparedness, emergency preparedness, fire, and life safety, payroll-based journal (PBJ), and the CMS Five-Star Quality Rating System on Nursing Home Compare.  

F-TAG ACTION BRIEFS, TOOLS & MORE ON ROP

Discover action briefs and tools to help you better understand the Phase 2 updates and Phase 3 new guidance, including F-Tag Action Briefs, which complement weekly Focus F-Tag summaries and feature implementation strategies and tips. 

REVIEW ACTION BRIEFS     REVIEW TOOLS

  • TOOLS - Instruments to help you implement the ROP.

Additional Resources

  • Contains 4 Component(s)

    The CMP Analytical tutorial and webinar walks through how to use the CMP Analytical tool on QCOR to predict what your CMPs will be, based on the survey results. Registration is free to AHCA/NCAL members.

    QCOR provides Skilled Nursing Facilities and other provider types with survey data and other reports related to the enforcement of regulatory areas.  The tutorial describes how facilities can use QCOR to review trends and data related to survey histories in skilled nursing.  The CMP Analytical tutorial and webinar walks through how to use the CMP Analytical tool on QCOR to predict what your CMPs will be, based on the survey results.  

    Registration is free to AHCA/NCAL members. 
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.

    © 2024 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

  • Contains 2 Component(s)

    Building a Lasting Relationship with Surveyors is a tool prepared by the AHCA Survey Regulatory Committee. The tool provides useful information on preparing for surveys, ahead of the survey by building lasting relationships with surveyors. Additionally, the tool provides best practices for during a survey, and after the survey is complete. Finally, there are resources within the provided webinar, as well as audit tools to prepare for surveys, and for use during a survey. This is free and accessible to AHCA members only.

    Building a Lasting Relationship with Surveyors is a tool prepared by the AHCA Survey Regulatory Committee.  The tool provides useful information on preparing for surveys, ahead of the survey by building lasting relationships with surveyors.  Additionally, the tool provides best practices for during a survey, and after the survey is complete.  Finally, there are resources within the provided webinar, as well as audit tools to prepare for surveys, and for use during a survey.  

    This is free and accessible to AHCA members only. 
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register. 
    Email educate@ahca.org if you need assistance with registering. 

    © 2023 American Health Care Association. All rights reserved. All Building a Lasting Relationship with SurveyorsBefore, During, and After Surveys materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

  • Contains 1 Component(s)

    The provision of care and services offered by nursing homes must be individualized and person-centered, and equally and universally applied to all residents including those who identify as transgender or gender diverse (TGD). Furthermore, as a condition of licensure, the nursing home must remain in compliance with federal, state, and local laws and professional standards, which includes requirements of nondiscrimination. Registration is free for AHCA/NCAL members.

    The provision of care and services offered by nursing homes must be individualized and person-centered, and equally and universally applied to all residents including those who identify as transgender or gender diverse (TGD). Furthermore, as a condition of licensure, the nursing home must remain in compliance with federal, state, and local laws and professional standards, which includes requirements of nondiscrimination.  The areas of consideration in this resource document provide nursing homes with suggestions for 1. Policies and procedures, 2. Resident rights, 3. Admitting and collection of gender identity data, 4. Staff education, 5. Resident education, and 6. Resident room placement and bathroom considerations. While these areas of consideration are limited to specific topics and are not all inclusive of areas a nursing home should consider when developing policies and procedures or best practices related to providing care and services for LGBTQ+ older adults, they do provide a framework for discussion and practice. All considerations should be used in conjunction with the inclusion of federal and state laws, legal counsel, and ethics committee feedback. 

    Registration is free to AHCA/NCAL Members
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.


    © 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

  • Contains 4 Component(s)

    The Accidents Webinar will review regulations related to supervision to avoid accidents. It also pulls together various resources available on ahcancalED, as well as external resources. The Webinar provides resources for development of policies to remain compliant with accident regulations. Finally, real-life case studies will be reviewed with explanations for what facilities should do if similar events occur. This webinar is $30 for AHCA/NCAL members. $65 Non-members

    The Accidents Webinar will review regulations related to supervision to avoid accidents.  It also pulls together various resources available on ahcancalED, as well as external resources.  The Webinar provides resources for development of policies to remain compliant with accident regulations.  Finally, real-life case studies will be reviewed with explanations for what facilities should do if similar events occur.

    Registration is $40 AHCA/NCAL Members | $80 Non-members
    1.25 NAB approved CEs are available upon completion and 1.0 contact hours for nurses through the Iowa Board of Nursing.
    Audience: Facility leadership, DONs, and Administrators, Regional Staff
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.

    © 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.


  • Contains 9 Component(s)

    On August 24, 2023, CMS released the final MDS Item Sets version 1.18.11v5 and on August 22, 2023, they released the final MDS 3.0 RAI User’s Manual version 1.18.11. AHCA has developed tools to assist with implementation of the new changes. These tools cover the changes to the MDS 3.0 Final Item set as well as incorporate the RAI manual guidance into considerations for application. Registration is free to AHCA/NCAL Members.

    On August 24, 2023, CMS released the final MDS Item Sets version 1.18.11v5 and on August 22, 2023, they released the final MDS 3.0 RAI User’s Manual version 1.18.11. AHCA has developed tools to assist with implementation of the new changes. These tools cover the changes to the MDS 3.0 Final Item set as well as incorporate the RAI manual guidance into considerations for application. 

    Registration is free to AHCA/NCAL Members 
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.



    © 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.

  • Contains 3 Component(s)

    This pressure injury prevention and wound management webinar is presented by Jeanine Maguire, a wound consultant and educator with almost 3 decades of wound care focus and expertise. In this webinar, Jeanine emphasizes a patient-centric approach and the importance of routine and comprehensive risk assessment and skin checks. She discusses the challenges of Deep Tissue Injury and the controversy over whether pressure injuries are a result of end-of-life or a combination of factors. Jeanine highlighted the need for accurate documentation and understanding of medically unavoidable wounds. She also stresses the importance of a multidisciplinary team approach, ongoing monitoring, and communication. Lastly, Jeanine provides links to CMS F tag 686, the critical element pathway, PAWSIC (the Wound Provider Group checklist), and NPIAP for further reference. *Note that some information shared will change with the RAI updates in October, but the presentation discusses how to prepare for those changes. Registration is free to AHCA/NCAL Members | $65 Non-members

    This pressure injury prevention and wound management webinar is presented by Jeanine Maguire, a wound consultant and educator with almost 3 decades of wound care focus and expertise. In this webinar, Jeanine emphasizes a patient-centric approach and the importance of routine and comprehensive risk assessment and skin checks. She discusses the challenges of Deep Tissue Injury and the controversy over whether pressure injuries are a result of end-of-life or a combination of factors. Jeanine highlighted the need for accurate documentation and understanding of medically unavoidable wounds. She also stresses the importance of a multidisciplinary team approach, ongoing monitoring, and communication. Lastly, Jeanine provides links to CMS F tag 686, the critical element pathway, PAWSIC (the Wound Provider Group checklist), and NPIAP for further reference. *Note that some information shared will change with the RAI updates in October, but the presentation discusses how to prepare for those changes.  

    Speaker:

    Jeanine Maguire, PhD, MPT, CWS, SeekingWhole, Wound Education and Consulting. PAWSIC.org

    Registration is free to AHCA/NCAL Members | $65 Non-members
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.

    Jeanine Maguire, PhD, MPT, CWS

    Seekingwhole, LLC

    PAWSIC.org

    Jeanine provides consulting services to healthcare organizations focused on healthcare management, clinical operations, and quality improvement.

  • Contains 5 Component(s)

    Both the toolkit, and the webinar, were developed to assist facilities in regard to regulations related to abuse, neglect, and misappropriation of resident property, how and when to report abuse, how to complete an abuse investigation, and helpful tips for achieving past noncompliance (PNC) for these deficiencies. This training toolkit is free to AHCA/NCAL members. $65 Non-members

    This three-part webinar reviews regulations related to abuse, neglect, and misappropriation of resident property, how and when to report abuse, how to complete an abuse investigation, and helpful tips for achieving past noncompliance (PNC) for these deficiencies.  The webinars also include real life scenarios, how to avoid deficiencies in these scenarios, and tools for achieving PNC.

    Registration is free to AHCA/NCAL Members | $65 Non-members
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.

    © 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.


  • Contains 3 Component(s)

    Discharges, Making the Safest Transition for your Residents is a Webinar created by AHCA Regulatory staff to assist facility staff in understanding regulations related to planning, preparing, and discharging residents safely. The Webinar provides real-life scenarios of difficult discharge situations, and how to stay in compliance when these situations arise. Registration is free to AHCA/NCAL Members | $65 Non-members

    Discharges, Making the Safest Transition for your Residents is a Webinar created by AHCA Regulatory staff to assist facility staff in understanding regulations related to planning, preparing, and discharging residents safely.  The Webinar provides real-life scenarios of difficult discharge situations, and how to stay in compliance when these situations arise.

    Registration is free to AHCA/NCAL Members | $65 Non-members
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.

    © 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.


  • Contains 3 Component(s)

    Both the toolkit, and the webinar, were developed to assist facilities in determining if an IDR is an appropriate tool to use after survey where the results need to be disputed, by the facility. This training toolkit is free to AHCA/NCAL members. $65 Non-members

    A sub-group of the Survey Regulatory Committee developed the webinar and toolkit titled Informal Dispute Resolution (IDR).  Both the toolkit, and the webinar, were developed to assist facilities in determining if an IDR is an appropriate tool to use after survey where the results need to be disputed, by the facility.  Additionally, the webinar assists facilities through the process of completing an IDR and informs learners about areas that may vary based on state processes.  The IDR process is not one providers do often so this tool is a helpful aide in completing a task that can sometimes seem confusing and intimidating.    

    Registration is free to AHCA/NCAL Members | $65 Non-members
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.
    Email educate@ahca.org if you need assistance.

    © 2023 American Health Care Association. All rights reserved. Materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association.


  • Contains 1 Component(s)

    This educational webinar walks through the CMS nursing home life safety inspection process, provides an overview of the applicable codes and standards, addresses how to access and navigate the codes, identifies CMS survey tools and reports, and discusses some of the most commonly cited life safety deficiencies. This webinar is available free to AHCA/NCAL members and $65 non-members.

    Healthcare is a heavily regulated industry.  For nursing homes in particular, the requirements are complicated and the inspection process is unique.  Managing life safety compliance can be daunting for even the experienced Facilities Manager.  The learning curve for someone new to the industry can be overwhelming.  This educational webinar walks through the CMS nursing home life safety inspection process, provides an overview of the applicable codes and standards, addresses how to access and navigate the codes, identifies CMS survey tools and reports, and discusses some of the most commonly cited life safety deficiencies.   

    This webinar is available to both AHCA/NCAL members and non-members.
    Cost: Free to AHCA/NCAL Members
    $65 for Non-members 
    Follow the Instructions Below to Register: 
    • To avoid technical problems, use Google Chrome. 
    • Members will need to log in using their existing email and password first. 
    • Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
    • If you have forgotten your password click here
    • If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register for the webinar. 
    Email educate@ahca.org if you need assistance with registering. 

    © 2023 American Health Care Association. All rights reserved. Survey Preparation for the New Facilities Manager materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of the American Health Care Association.

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