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Incontinence Issues and the Long-Term Care Survey Process

Optimal facility results with an effective continence management program

By Michele Mongillo, RN, MSN

This article explores the state survey process in relation to federal tag 315 (F-315). Long-term care facilities encounter numerous challenges in relation to incontinence. This article will define the background of the F-315 regulation and its components, offer recommendations to help you always be survey ready and discuss examples of actual citations.

The facility Minimum Data Set (MDS) is a key assessment component for every long-term care facility as they evaluate their residents' incontinence status and develop an individualized plan of care. Facilities can be fully prepared for a survey by having a continence management program in place on a daily basis and always being survey ready.

In June of 2005, the Centers for Medicare & Medicaid Services (CMS) released the revised regulation that encompasses F-315. This revision included the integration of F-315 and F-316 tags. The intent of F-315 includes1:

  • In the event a resident is incontinent of urine, they are assessed and provided treatment and services to achieve and/or maintain as much urinary function as possible
  • In the event a resident has a indwelling catheter, there is medical justification
  • A resident with or without an indwelling catheter receives care to prevent urinary tract infections when possible
As of March 2010, F-315 remains in the top 10 most frequently cited deficiencies in the nation. According to CMS Online Survey, Certification and Reporting (OSCAR) data, 16.5 percent of nursing homes were cited for F-315 in the first quarter of 2010. A total of 2,586 facilities out of 15,694 received an F-315 citation.2

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