Federal Oversight Support Survey (FOSS) Expectations and

4158 - Federal Oversight Support Survey (FOSS) Expectations and Responsibility (Rev. 1, 05-21-04) 4158A - SA Responsibility (Rev. 1, 05-21-04) Once the survey schedule has been prepared, the SA should forward this schedule to the RO at least two weeks prior to the earliest survey date. This schedule should include: ● Survey dates (including projected end date) ● Facility name and provider number ● SA surveyor names or initials, with the identification of the team leader ● Any use of specialty surveyors ● Type of survey (initial, recertification, complaint, etc) Once the survey schedule has been forwarded to the RO, and/or the SA has been notified of the selection for Federal oversight, the SA must notify the RO prior to the survey regarding any survey changes (for those selected for FOSS surveys). Changes may be defined as increasing or decreasing team size and composition, altering the survey date, and changing locations. SA justification should accompany the communication of such changes. During a FOSS, the SA surveyors must inform the RO surveyors when they are or will be conducting certain functions during the survey process. These include, at a minimum: ● Interviews (with staff, family and/or residents) ● Team meetings ● Observations of care delivery The SA team will share all survey documentation with the RO surveyor(s) for review. The SA team must determine if Harm, Substandard Quality of Care and/or Immediate Jeopardy are present during the information gathering tasks of the survey and/or during information analysis and decision-making. Once the FOSS and SA survey have concluded and the SA has documented the compliance decisions, the SA must forward the CMS-2567 to the RO at the same time the CMS-2567 is forwarded to the facility. 4158B - RO Responsibility (Rev. 1, 05-21-04) The RO, in preparation for the survey, shall review the survey schedule provided by the SA and notify the State Agency when a survey has been selected for a FOSS. However, an RO may select a survey for an unannounced FOSS. The RO, in conducting a FOSS will generally perform several steps in gathering information about survey team performance. These include: ● Observing surveyors ● Talking with SA surveyors to clarify observations and interpretations ● Reviewing facility documentation and surveyor notes ● Conducting limited fact finding ● Attending survey team meetings. The RO surveyor must be able to be present at as many interviews as possible with residents and key facility staff. In addition, the evaluator must be able to be present during all team meetings, investigative activities and during resident care observations as appropriate for their discipline. The RO surveyor(s) may perform limited fact finding in order to assess the SA survey team’s achievement of outcome measures associated with assessing a provider’s compliance with Federal regulations. (See FOSS Manual for guidance) The RO team must provide evaluators to ensure RO to SA ratios of 1:2, but no less than 1:3. The RO surveyors shall not remain on-site if the SA survey team has ended that day’s observations and investigations. When the SA leaves the facility, the RO should also depart. The RO team will debrief the SA survey team regarding the effectiveness of it’s survey behaviors in achieving the goals and outcomes of the survey following the completion of the survey, or within the first week the State survey team and RO surveyors return to the office. The RO team will also document the SA team’s performance on each outcome that was observable during the survey, and rate that performance by assigning the team a numerical score on each outcome. If appropriate, the RO team will identify SA team training needs. Upon the conclusion of the FMS (FOSS), the RO team will provide SA management with written feedback on the FOSS at two key points: ● Within 30 days after the completion of the survey, the FOSS Rating and Documentation Form will be provided to the SA. ● Within 30 days after receipt of the facility copy of the Form CMS-2567 by the RO, the FOSS Evaluation Form for Form CMS-2567 will be provided to the SA.