CHS Pharmacy News

March 2025

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CMS Long-Term Care (LTC) Surveyor Guidance Updates*

The Centers for Medicare and Medicaid Services (CMS) will implement major updates to long-term care survey guidelines on March 24, 2025. These revisions address admission agreements, medication management, infection control, and health equity while streamlining the survey process and improving accuracy in Minimum Data Set (MDS) assessments. Surveyors must now review MDS coding accuracy, and patterns of deliberate inaccuracies affecting three or more residents will be referred to the Office of the Inspector General for investigation.

Key changes include prohibiting third-party payment guarantees in admission agreements to prevent financial coercion and replacing outdated transfer and discharge tags with two new citations for clearer compliance identification. Psychotropic medication guidelines now stress informed resident participation, while infection control updates require enhanced precautions for multidrug-resistant organisms (MDROs) and mandatory COVID-19 vaccine education and access.

CMS also strengthens oversight of medication practices and health equity. Medical directors must enforce care policies, and Quality Assurance and Performance Improvement (QAPI) programs must track health equity data like race and socioeconomic status. Updated Long-Term Care Survey Process (LTCSP) software and training through the Quality, Safety, and Education Portal (QSEP) will support these changes, with new survey documents available before March 24, 2025.

Administration Tip: Nebulizers**

Nebulizers should be used according to the manufacturer’s instructions. To set up and operate a nebulizer:

• Wash hands thoroughly.
• Assemble the nebulizer by connecting one end of the hose to the air compressor, filling the medicine cup with the prescribed medication (ensuring it is tightly closed and held upright), and attaching the other end of the hose to the mouthpiece and medicine cup.
• Turn on the nebulizer.
• Administer the medication by placing the mouthpiece in the mouth with lips sealed around it or using a facemask securely over the mouth and nose.
• Breathe slowly and deeply through the mouth until the medicine is fully delivered, which typically takes 5 to 20 minutes.
• After the treatment, turn off the nebulizer and clean the medicine cup and mouthpiece with water, allowing them to air dry until the next use.

Regular cleaning and maintenance are essential for safe and effective treatments.

1. * cms.gov
2. ** medlineplus.gov