Current LTCSP Critical Element Pathways (4/28/2025 Edition)

Looking for the 4/28/2025 Critical Element Pathways? See all the current documents below so you can be prepped for your next survey.

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Critical Element Pathways that have not changed

SNF Beneficiary Notification Review 10/2022 (CMS-20052 Beneficiary Notice)

Dining Observation 10/2022 (CMS-20053 Dining)

Infection Prevention, Control & Immunizations 8/2024 (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)

Resident Council Interview 10/2022 (CMS-20057 Resident Council)

Abuse Critical Element Pathway 10/2022 (CMS-20059 Abuse)

Environmental Observations 10/2022 (CMS-20061 Environment)

Personal Funds Review 10/2022 (CMS-20063 Personal Funds)

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)

Urinary Catheter or Urinary Tract Infection Critical Element Pathway 4/2024 (CMS-20068 Urinary Catheter or UTI)

Communication and Sensory Problems (Includes Hearing and Vision) Critical Element Pathway 10/2023 (CMS-20069 Comm-Sensory)

Dental Status and Services Critical Element Pathway 4/2024 (CMS-20070 Dental)

Dialysis Critical Element Pathway 4/2024 (CMS-20071 Dialysis)

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)

Death Critical Element Pathway 10/2023 (CMS-20074 Death)

Nutrition Critical Element Pathway 10/2023 (CMS-20075 Nutrition)

Physical Restraints Critical Element Pathway 10/2023 (CMS-20077 Physical Restraints)

Pressure Ulcer/Injury Critical Element Pathway 4/2024 (CMS-20078 Pressure Ulcer)

Specialized Rehabilitative or Restorative Services Critical Element Pathway 10/2023 (CMS-20080 Rehab and Restorative)

Medication Storage and Labeling 6/2023 (CMS-20089 Medication Storage)

Preadmission Screening and Resident Review Critical Element Pathway 10/2023 (CMS-20090 PASARR)

Extended Survey 8/2024 (CMS-20091 Extended Survey)

Hydration Critical Element Pathway 10/2023 (CMS-20092 Hydration)

Tube Feeding Status Critical Element Pathway 4/2024 (CMS-20093 Tube Feeding)

Positioning, Mobility & Range of Motion (ROM) 10/2023 (CMS-20120 Positioning, Mobility, ROM)

Bladder or Bowel Incontinence Critical Element Pathway 10/2023 (CMS-20125 Bladder and Bowel Incontinence)

Neglect Critical Element Pathway 10/2022 (CMS-201230 Neglect)

Dementia Care Critical Element Pathway 10/2023 (CMS-20133 Dementia Care)

Binding Arbitration Agreement Review 5/2023 (CMS-20140 Arbitration)

Updated Critical Element Pathways

Here are the revised Critical Element Pathways effective April 28, 2025:

Sufficient and Competent Nurse Staffing Review (CMS-20062 4/2025)

Respiratory Care Critical Element Pathway (CMS-20091 4/2025)

Quality Assurance & Performance Improvement (QAPI) and Quality Assessment & Assurance (QAA) Review (CMS-20058 4/2025)

Pain Recognition and Management Critical Element Pathway (CMS-20076 4/2025)

Unnecessary Medications, Chemical Restraints/Psychotropic Medications and Medication Regimen Review Critical Element Pathway (CMS-20082 4/2025)

Hospitalization Critical Element Pathway (CMS-20123 4/2025)

Accidents Critical Element Pathway (CMS-20127 4/2025)

Resident Assessment Critical Element Pathway (CMS-20131 4/2025)

Discharge Critical Element Pathway (CMS-20132 4/2025)

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