Proactive Survey Preparation: Essential Risk Management for Skilled Nursing Facilities

07/01/2024 Written by: AP Senior Living

Staying informed about the latest trends and requirements in long-term care facilities is crucial. Our webinar, "Managing Your Survey: The Top 10 Survey Citation Trends," offers valuable insights into the most common deficiencies cited in skilled nursing facilities (SNFs) and emphasizes proactive measures that can be taken to mitigate risks and ensure compliance. Here, we will delve into the key points from the webinar and provide an insurance perspective on managing these risks effectively.

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Top Ten Cited Deficiencies in Skilled Nursing Facilities

Understanding the most frequently cited deficiencies can help SNFs and their insurance providers identify potential risks and implement mitigation strategies. The top ten deficiencies cited in fiscal year 2023 include: 

  1. Accurate and timely reporting to the National Healthcare Safety Network (NHSN) is critical. Failure to report within the required timeframe can result in citations and penalties.
  2. Ensuring a safe environment free from accident hazards and providing adequate supervision is essential. Facilities must have comprehensive systems in place to identify, evaluate, and mitigate risks.
  3. Effective infection control practices, including screening, testing, isolation, and staff training, are paramount, especially in the post-COVID-19 era.
  4. Proper food procurement, storage, and sanitary practices are needed to prevent foodborne illnesses and ensure resident safety.
  5. Facilities must provide treatment and care that meet professional standards and address the comprehensive needs of residents, including end-of-life care.
  6. Developing and implementing comprehensive, individualized care plans that are regularly updated is essential for resident well-being.
  7. Providing adequate assistance with Activities of Daily Living is vital, particularly for residents with higher levels of dependency.
  8. Properly labeling and storing medications and biologicals is necessary to prevent contamination and medication errors.
  9. Promptly reporting allegations of abuse, neglect, or exploitation is critical to maintaining compliance and protecting residents.
  10. Facilities must implement policies and procedures to protect residents from all forms of abuse, neglect, and exploitation.

Risk Management Strategies

To effectively manage these risks, SNFs and their insurance providers can adopt several proactive strategies:

  1. Continuous training for staff on the latest regulations, infection control practices, and resident care standards is essential. Using resources like the Medicare Learning Network can provide valuable training modules.
  2. Thorough and timely documentation of resident assessments, care plans, and incident reports is crucial. Facilities should regularly review and update care plans to reflect any changes in resident conditions.
  3. Critical element pathways for various areas, such as accident hazards and abuse, can guide staff in providing consistent and comprehensive care. These pathways are also helpful for internal audits and training.
  4. Effective communication between all stakeholders, including staff, residents, families, and external healthcare providers, is vital. Regularly scheduled meetings and clear protocols can facilitate this communication.
  5. Numerous resources are available to SNFs, such as the National Pressure Injury Advisory Panel Toolkit and the Center for Excellence for Behavioral Health in Nursing Facilities. These resources offer guidance on best practices and preventive measures.


Proactive risk management in skilled nursing facilities is essential to ensuring compliance, enhancing resident safety, and mitigating potential liabilities. By understanding the most common deficiencies and implementing effective strategies, SNFs can provide high-quality care while minimizing risks. The AssuredPartners Senior Living team supports facilities with the necessary tools and resources to foster a safe and compliant healthcare environment.

Gain deeper insights into managing survey citations and proactive risk management, watch the recording of our webinar, "Managing Your Survey: The Top 10 Survey Citation Trends.”

Managing Your Survey: The Top 10 Survey Citation Trends.

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