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SNF Inspection Survey for End of Life Cheat Sheet by

SNF Inspection Survey for End of Life
end     life     survey     snf     healthcare     inspection

End of Life Care: Assessment & Problem Recogn­ition

May relate to F Tag: 272 (Asses­sment), 309 (Quality Of Care
1. Did the facility identify the impact or implic­ations of an acute illness or current condition for the resident’s long-term prognosis (outlook)?
2. Did the facility identify and collect documents and other inform­ation related to advance care planning (advance direct­ives, other written instru­ctions, etc.) that were relevant to carrying out the resident’s wishes related to end-of­-life care?
3. Did the facility determine and document an indivi­dual’s decisi­on-­making capacity approp­ria­tely?
4. Did the facility hold and document conver­sations or meetings with the approp­riate decision- maker regarding end-of­-life issues?
5. Did the facility identify factors influe­ncing the indivi­dual’s decisi­on-­making capacity?
6. Did the facility inform the resident of the right to make decisions on his/her care or inform an approp­riate substitute decisi­on-­maker of the right to make decisions on behalf of an incapa­citated indivi­dual?

End of Life Care: Treatment & Problem Management

End of Life Care: Treatment and Problem Management
7. Does the facility have and consis­tently apply policies supporting the offering of altern­ative approaches for end-of­-life care or notify residents and families of signif­icant limita­tions to their choices?
8. Did the facility present relevant treatment or management options to a resident or substitute decisi­on-­maker?
9. Did the facility’s plan of care incorp­orate a resident’s wishes regarding the extent and aggres­siv­eness of interv­entions or treatm­ents?
10. Did the facility identify the specific elements to be given or withheld as part of a palliative care or “comfort care” plan?
11. Did the facility implement a palliative care plan consis­tently including relevant orders

End of Life Care: Monitoring

May relate to F Tag:27­9/280 (Compr­ehe­nsive Plans), 309 (Quality Of Care)
12. Did the facility review the plan related to end-of­-life care with the resident or substitute decisi­on-­maker when a signif­icant condition change occurred?
13. Did the facility modify the resident’s care plan to reflect changes in decisions by the resident or a substitute decision maker?

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