Preparing for survey? We know many providers land on outdated versions of CMS’s survey tools — which is why we always redirect you to the most current resources. The Centers for Medicare & Medicaid Services has issued multiple updates to the LTCSP Critical Element Pathways, with the latest revisions released in February 2026. To help you stay compliant and survey‑ready, here are the LTCSP survey resources that are currently in use.
Pathways with Revisions as of February 2026:
- CMS-20057 Resident Council Interview (2/2026)
- CMS-20058 Quality Assurance & Performance Improvement (QAPI) and Quality Assessment & Assurance (QAA Review) (2/2026)
- CMS-20082 Unnecessary Medications, Chemical Restraints/ Psychotropic Medications and Medication Regimen Review Critical Element Pathway (2/2026)
- CMS-20091 Extended Survey (2/2026)
- CMS-20132 Discharge Critical Element Pathway (2/2026)
- CMS-20081 Respiratory Care Critical Element Pathway (dated 1/2026)
If you want expert guidance navigating these requirements, view CMSCG’s Survey Readiness Consulting Services for proactive support.
Other Critical Element Pathways
The remaining CE Pathways were last updated in July 2025 or earlier. Click the file name to download:
Abuse Critical Element Pathway 10/2022 (CMS-20059 Abuse)
Accidents Critical Element Pathway 4/2025 (CMS-20127 Accidents)
Activities Critical Element Pathway 10/2023 (CMS-20065 Activities)
Activities of Daily Living (ADL) Critical Element Pathway 10/2023 (CMS-20066 Activities of Daily Living)
Behavioral and Emotional Status Critical Element Pathway 10/2023 (CMS-20067 Behavioral-Emotional)
Binding Arbitration Agreement Review 5/2023 (CMS-20140 Arbitration)
Bladder or Bowel Incontinence Critical Element Pathway 10/2023 (CMS-20125 Bladder and Bowel Incontinence)
Communication and Sensory Problems (Includes Hearing and Vision) Critical Element Pathway 10/2023 (CMS-20069 Comm-Sensory)
Death Critical Element Pathway 10/2023 (CMS-20074 Death)
Dementia Care Critical Element Pathway 10/2023 (CMS-20133 Dementia Care)
Dental Status and Services Critical Element Pathway 4/2024 (CMS-20070 Dental)
Dialysis Critical Element Pathway 4/2024 (CMS-20071 Dialysis)
rom systems reviews to ongoing compliance support, our team helps facilities strengthen operations and reduce survey risk.
Dining Observation 10/2022 (CMS-20053 Dining)
Environmental Observations 10/2022 (CMS-20061 Environment)
General Critical Element Pathway 2/2017 (CMS-20072 General)
Hospice and End of Life Care and Services Critical Element Pathway 5/2017 (CMS-20073 Hospice and End of Life)
Hospitalization Critical Element Pathway 4/2025 (CMS-20123 Hospitalization)
Hydration Critical Element Pathway 10/2023 (CMS-20092 Hydration)
Infection Prevention, Control & Immunizations 7/2025 (CMS-20054 Infection Prevention Control and Immunization)
Kitchen/Food Service Observation 10/2022 (CMS-20055 Kitchen)
Medication Administration Observation 11/2017 (CMS-20056 Med Admin)
Medication Storage and Labeling 6/2023 (CMS-20089 Medication Storage)
Neglect Critical Element Pathway 10/2022 (CMS-201230 Neglect)
Nutrition Critical Element Pathway 10/2023 (CMS-20075 Nutrition)
Pain Recognition and Management Critical Element Pathway 4/2025 (CMS-20076 Pain Mgt)
Personal Funds Review 10/2022 (CMS-20063 Personal Funds)
Physical Restraints Critical Element Pathway 10/2023 (CMS-20077 Physical Restraints)
Positioning, Mobility & Range of Motion (ROM) 10/2023 (CMS-20120 Positioning, Mobility, ROM)
Preadmission Screening and Resident Review Critical Element Pathway 10/2023 (CMS-20090 PASARR)
Pressure Ulcer/Injury Critical Element Pathway 4/2024 (CMS-20078 Pressure Ulcer)
Resident Assessment Critical Element Pathway 4/2025 (CMS-201315 Resident Assessment)
SNF Beneficiary Notification Review 10/2022 (CMS-20052 Beneficiary Notice)
Specialized Rehabilitative or Restorative Services Critical Element Pathway 10/2023 (CMS-20080 Rehab and Restorative)
Sufficient and Competent Nurse Staffing Review 4/2025 (CMS-20062 Sufficient and Competent Staff)
Tube Feeding Status Critical Element Pathway 4/2024 (CMS-20093 Tube Feeding)
Urinary Catheter or Urinary Tract Infection Critical Element Pathway 4/2024 (CMS-20068 Urinary Catheter or UTI)
To download the current CMS LTCSP Resources Folder (2/3/2026), click the button below. This is a .zip folder.
