However, the federal requirements for participation in the Medicare program are the minimum standards allowed. If the federal government determines that a facility is out of compliance, its determination is binding over the state s determination of compliance. If the state has determined that the facility is out of compliance, but the federal agency finds compliance, the state s determination controls. Surveys of nursing homes are performed to certify that new facilities are in compliance with applicable standards, to ensure that existing facilities maintain compliance with quality standards through routine periodic surveys, and to respond to complaint allegations. Surveyors are required to focus on the impact of the treatment on the residents health and safety rather than simply reviewing the facility s policies and procedures for rendering care.
Resident interviews are part of the survey process.
When determining whether a remedy should be imposed, surveyors consider the seriousness of the deficiency or deficiencies by analyzing the scope and severity and applying a formula based on a scope and severity grid. One or more of several remedies may be imposed for failure to maintain substantial compliance. A pending appeal does stay the imposition of enforcement remedies except where civil money penalties are imposed.