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F309 puts pressure on pain management

PPS Alert for Long-Term Care, May 1, 2009

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to PPS Alert for Long-Term Care.

Pain management in nursing homes is under more scrutiny than ever. CMS recently released and implemented major new pain management guidance and investigative protocols for long-term care surveyors under the survey deficiency F309, quality of care. The guidance gives surveyors the direction to cite facilities that aren’t properly assessing and treating pain with deficiencies. Previously, nursing facilities were expected to address and manage pain, but nursing homes and surveyors did not have specific guidelines to do so, says Marilyn Mines, RN, BC, RAC-CT, manager of clinical services at FR&R Healthcare Consulting, Inc., in Deerfield, IL.
“Overall, in the industry, it’s been felt that pain has been ignored in the geriatric population, and hence, now we have a [survey] protocol that’s extremely complex,” Mines says.
To comply with F309, nursing facilities must reexamine how they assess and manage pain in residents, including the use of pain medications, PRN (i.e., “as needed”) medication regimens, and the use of complimentary and alternative medicine (CAM). Clinicians may need to become better at identifying pain in cognitively impaired residents or overcome biases about pain.
Nursing facilities must assess and address pain in all residents, including the cognitively impaired, according
to the pain management guidance under F309.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to PPS Alert for Long-Term Care.

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