Gettyimages 1218311009 Cleaning And Sanitizing

After a nearly six-month hiatus from inspections, the Centers for Medicare and Medicaid Services (CMS) announced routine surveys of Medicare and Medicare certified provider will resume. Now that annual surveys are once again underway, long-term care facilities are faced with the challenges of keeping up with not only the heightened sanitation practices, but also the evolving recommendations and guidance from state and federal agencies. This includes dining practices, resident and staff testing, safety precautions, and infection control practices. While staff is becoming accustomed to the procedures for daily COVID-19 screening, continued vigilance is essential to ensure all staff are adhering to proper procedures, as CMS has increased enforcement, including civil money penalties for persistent infection control violations.  Surveys in general can be stressful for staff, assuring your staff are adequately prepared, through continued training and ensuring all required supplies on are hand, can set your team up for success even during the COVID-19 pandemic.

Surveys will include a larger focus on a facility’s infection control in all departments. Additional considerations during the COVID pandemic may include:

  • Ensuring staff knows and can explain the facility’s policy for sick leave, screening system in place for COVID, and procedure in the event someone reports symptoms or tests positive.
  • Understand and be able to demonstrate how COVID-19 can be spread, proper use of personal protective equipment (PPE), removal and disposal of PPE, proper handwashing for at least 20 seconds.
  • Following cleaning and sanitizing/disinfecting practices, not only in the kitchen but on nursing units, resident rooms, and any common areas, including any area being used as a dining room.
  • Cleaning logs and schedules must be kept up to date to ensure all areas are properly sanitized. Additional cleaning and sanitizing may be needed in high traffic/touch areas.
  • Identify how meals services are being handled, including when and where residents are eating, who is delivering the meal trays, how tray service and temperatures are being monitored (including use of test trays), meal and snack alternatives to entice appetites, and who is assisting or supervising residents in dining areas, including resident rooms.
  • Providing additional in-services and trainings on sanitation practices and kitchen protocol on regular intervals.

Preparedness can also mean being aware of new changes. The Centers for Medicare and Medicaid Services (CMS) released new guidelines for communal dining and activities as of September 17th: ‘residents may eat in same room with social distancing (limited number of residents at each table with six feet of distance between each person).’ Activities may also be conducted with social distancing practices, face coverings, and proper hand hygiene. Staff must perform hand hygiene and change PPE as appropriate in between assisting residents. Staff should also clean and disinfect all surfaces between meal shifts and activities.

The Centers for Medicare and Medicaid Services (CMS)  is also monitoring to see continued communication with residents and their families, including any changes to resident schedules, infection control practices, or visitation, as well as working with residents and their families on keeping connected during these times of limited in person visitation. COVID-19 Focused Survey for Nursing Homes now include two new F-Tags per CMS: F884 (COVID-19 Reporting to CDC) and F885 (COVID-19 Reporting to Residents, their Representatives, and Families.)

With these challenging times, it is important all lines of communication remain open, including those within each facility and between departments, to ensure all staff are on the same page and are confident when entering into a survey. Facilities can also take advantage of COVID-19 focused survey tools and pathways available, plus additional in-servicing materials offered from your food service representative and Registered Dietitian (RD). Your RD can provide resources and tips, as well as perform audits and in-services for all levels of staff to support you in preparation and completion of a survey.


Nursing Home Visitation – COVID-19. (2020, September 17). Retrieved from

Brown, D. (2020, August 18). Feds restart regular survey inspections at nursing homes – News. Retrieved 2020, from

O’Brien S. (2020, August 19). Preparing Your Long-Term Care Facility for Survey During COVID-19. Retrieved from