Long Term Care Guidelines: Get a Lowdown on F309 Survey Guidance On Pain

With all the problems with pain management and nursing homes, it's not too surprising that effective pain management has become a focus of clinicians and regulators in recent years. Go through this expert long term care training article and know the the central thrust of the F309 survey guidance on pain.

Surveyors have been looking at pain all along as a part of the overall survey process. But now, there's a new guidance for the surveyors updating the quality of care F tag which F309. And the actual regulation is what is passed by Congress. And then the guidance to surveyors is sort of it's the policy. It's the implementation of the law.

So F309, you can find the regulation. It's 483.25. So this is the Federal Regulation F309 that spells out the nursing home’s mandate that hopefully you've all heard many times that each resident must receive and the facility must provide the necessary care and services to attain and maintain the highest practicable physical, mental and psychosocial wellbeing in accordance with the comprehensive assessment plan of care.

So this is the tag that includes quality of care issues such as pressure ulcers, urinary incontinence, ADLs and others. And so, now, they've added prevention and management of pain to the long term care guidelines. And you have much of this guidance to surveyors.

As far as the surveyor review of pain goes, the focus is on the resident who has pain symptoms, residents who are being treated for pain, residents who have the potential for pain symptoms related to conditions or treatments that they have or will be receiving. And also residents who are identified by the surveyors as being at risk for pain.

In order to help a resident attain or maintain his or her highest practicable level of wellbeing, the expectation is that the facility will to the extent possible, recognize whether resident is experiencing pain, identify circumstances when pain can be anticipated and evaluate existing pain and its causes.

The expectation is that the facility will to the extent possible manage or prevent pain. And those efforts must be consistent with the comprehensive assessment, the plan of care. Current clinical standards of practice and that's, you know, a pretty big deal.

And then of course, as per the long term care guidelines, the efforts must be consistent with the resident’s goals and preferences, talking to the resident about it, having the resident be an active part of identifying goals and making decisions is a big part of it.

In terms of the overview of the surveyor’s review of pain, effective pain recognition in management requires an ongoing facility wide commitment to and it goes on to explain resident comfort, identifying an addressing barriers to managing pain. Sometimes there are resident barriers too of course. And addressing misconceptions that resident’s families and staff might have about managing pain.

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