CMS Long Term Care Survey Process (LTCSP)


What is the Long Term Care Survey Process (LTCSP)? 

The LTCSP is the federal long term care survey process effective November 28, 2017. The LTCSP is a resident centered, outcome oriented inspection that relies on a case mix stratified sample of residents to gather information about skilled nursing facility and nursing facility compliance with participation requirements. The LTCSP uses customized software on tablet personal computers (PCs) to guide surveyors through offsite preparation and onsite interviews, observations, and limited record review; facility task review; and investigation of identified areas of concern. 


The LTCSP was designed to achieve several objectives:

  • Replace the two previously used long term care survey processes, QIS and the traditional survey process, with a single survey process used across the nation;
  • Provide a semi-structured process that supports the accurate identification of quality of care and quality of life problems while also relying on surveyor expertise and judgment;
  • Support surveyors in systematically reviewing requirements and objectively investigating all regulatory areas with identified concerns;
  • Enable timely and effective feedback on survey processes for surveyors and managers; and
  • Provide tools for continuous improvement in implementing the survey process.


LTCSP Work at the University of Colorado

The Division of Health Care Policy and Research at the University of Colorado is under contract with the Centers for Medicare & Medicaid Services (CMS) to assist with national implementation, analysis, and refinement of the LTCSP. The project team provides onsite support to states requesting LTCSP implementation and operational support and is involved in designing and testing the LTCSP revisit and stand-alone complaint survey processes, as well as the federal oversight survey. The project team also creates, produces, and supports the use of after survey reports derived from LTCSP data. The reports are designed for use by state agencies and CMS regional offices to evaluate variation in LTCSP survey results and guide state and regional quality assurance activities. Additional efforts include analyzing initial implementation data and experiences to guide the refinement of the LTCSP processes, procedures, and resources for surveyors and states.