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Long Term Care Survey Process Resource Center

Welcome to the Indiana State Department of Health (ISDH) Long Term Care Survey Process Resource Center.  This Resource Center provides information, tools, and resources about the Long Term Care Survey Process (LTCSP). Skilled nursing facilities (SNF) and nursing facilities (NF) must be in compliance with federal requirements in 42CFR Part 483, Subpart B to receive payment under Medicare and/or Medicaid.   The LTCSP was developed by the Centers for Medicare and Medicaid Services (CMS) for to determine facility’s compliance with these federal requirements.  All states were required to implement this survey process. 

The LTCSP is a computer assisted guide to determine if certified nursing homes meet the Federal requirements.  

Announcements / Current News

The Indiana State Department of Health, Division of Long Term Care surveyors have completed the CMS required training for the Long Term Care Survey Process.  This new survey process became effective on November 28, 2017.  


Indiana State Department of Health
2 North Meridian Street
Indianapolis, IN 46204
(317) 233-1325 (ISDH Main Switchboard)

Director of Long Term Care
Brenda Buroker, RN
Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4B
Indianapolis, IN 46204
Email: bburoker@isdh.in.gov
Phone: (317) 234-7340
Fax:  (317) 233-7322

Director of Survey Supports & Guidance
Janelyn Kulik, RN
Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4B
Indianapolis, IN 46204
Email: jkulik@isdh.in.gov
Phone: 317-233-7480
Fax: 317-233-7322

Definitions and Acronyms

Acronyms used on this web site:

  • ASPEN – Automated Survey Processing Environment
  • ACO – ASPEN Central Office
  • ASE – ASPEN Survey Explorer
  • CEs – Critical Element Pathways
  • CMS – Centers for Medicare & Medicaid Services
  • FRI – Facility Reported Incidents
  • ISDH – Indiana State Department of Health
  • LTC – Long Term Care
  • LTCSP – Long Term Care Survey Process
  • MDS – Minimum Data Set
  • PSR – Post Survey Revisit
  • QAPI – Quality Assessment / Process Improvement

Description of Long Term Care Survey Process

The LTCSP will replace both the Traditional and Quality Indicator Survey (QIS) processes that were used throughout the nation. When designing this new survey process the strengths from both the Traditional and QIS were considered.  The new survey process not only allows surveyors flexibility, but also has computer-based pathways for care areas that are structured to assist with the investigation of concerns.  These pathways provide a framework to determine compliance with specific requirements. 

The LTCSP is resident-centered, which means resident-specific concerns identified through resident observations and resident or representative interviews are emphasized. The LTCSP provides consistency while allowing the surveyor autonomy and the ability to make decisions based on their expertise and judgment.  The overarching goal for the LTCSP is to have one unified survey process that effectively identifies survey outcomes in an efficient and consistent manner.

Resources / Forms / Tools

CMS Website 

Appendix PP State Operations Manual (Revised 11/22/2017) 

List of Revised FTags – Substandard Quality of Care 

S&C Memo: Revision to State Operations Manual Appendix PP for Phase 2 (Includes Training Information and Related Issues) 

F-Tag Crosswalk 

LTC Survey Entrance Conference - Updated 11/08/2017

LTC Survey Pathways - Updated 11/08/2017 

LTCSP Procedure Guide 

Matrix with instructions 

Survey Resources: