Regulator Updates

Pressure Injuries/Ulcers and F-tag 686 (previously F-tag 314)

Pressure Injuries/Ulcers are defined as any lesion caused by unrelieved pressure that results in damage to the underlying tissue(s) over a bony prominence.

Pressure Ulcer/Injury (PU/PI) refers to localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device. A pressure injury will present as intact skin and may be painful. A pressure ulcer will present as an open ulcer, the appearance of which will vary depending on the stage and may be painful. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by skin temperature and

CMS has a quality of care regulation for pressure ulcer prevention and management. It is called F-686 (Previously F-tag 314, TAG 314). The goal of the regulation is to insure that every patient entering a nursing home receives the highest level of care possible. Below are the requirements of the F-tag:

F686 Pressure Injuries/Ulcers

TAG F 686 (§483.25 Quality of Care) Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.

(1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable.

(2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing

The overall goal of F-tag 686 is:

1. Promote the prevention of pressure ulcer development;

2. Promote the healing of pressure ulcers that are present (including prevention of infection to the extent possible)

3. Prevent development of additional pressure ulcers.