LTCSP Critical Element Pathways (7/30/2025 Edition)

Preparing for survey? It’s important to ensure you’ve got the most current LTCSP Critical Element Pathways, as there have been revisions made throughout 2025. Here are the survey resources current in use:

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)

Dining Observation 10/2022 (CMS-20053 Dining)

*Discharge Critical Element Pathway 5/2025 (CMS-20132 Discharge)

Environmental Observations 10/2022 (CMS-20061 Environment)

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

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)

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

Resident Assessment Critical Element Pathway 4/2025 (CMS-201315 Resident Assessment)

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

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

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)

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

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

If you missed our “Changes to the LTCSP are here” post from July 31, 2025, check it out here. You’ll find important information about survey updates and the current Survey Resources file for your reference.