Common PCREE Inspection Failures — What Surveyors See and How to Avoid Them

Skilled nursing facilities often fail PCREE inspections because of poor documentation, skipped tests, or outdated procedures. Surveyors look for compliance with NFPA 99, CMS, and OSHA guidelines. By building an organized inventory, sticking to a risk-based testing schedule, and documenting every step, facilities can avoid citations and keep residents safe.

Why PCREE Matters in Skilled Nursing Facilities

Patient Care-Related Electrical Equipment (PCREE) refers to any medical device or electrical system that directly or indirectly touches residents in a healthcare setting. This includes infusion pumps, beds, lifts, monitors, and even electrical outlets in patient care areas.

Surveyors from CMS and state health departments pay close attention to PCREE because equipment failures can lead to serious resident harm, regulatory deficiencies, and costly penalties. The NFPA 99 Health Care Facilities Code sets standards for inspection and testing, and CMS surveyors frequently cite it during inspections.

The Most Common PCREE Inspection Failures

Based on reports from surveyors and facility audits, these are the issues that appear most often:

1. Missing or Incomplete Equipment Inventories

Surveyors often find that facilities don’t have a complete list of all PCREE devices. Without a master inventory, it’s impossible to prove compliance or show a consistent testing program.

2. Skipped or Overdue Testing

CMS and NFPA 99 require routine testing (often annual, sometimes risk-based). Many facilities get cited because testing schedules were missed, or devices went years without evaluation.

3. Failure to Document Test Results

Even if equipment is being tested, surveyors frequently cite facilities for missing paperwork. Documentation should include test date, results, corrective actions, and the name of the tester.

4. Improper Testing Methods

Some facilities rely on visual inspections alone. Surveyors expect electrical integrity checks, leakage current tests, and ground resistance measurements — not just a quick look-over.

5. Untrained Personnel Performing Inspections

Surveyors flag inspections done by staff without proper biomedical or electrical safety training. OSHA also expects competent personnel to handle equipment testing.

6. Ignored Outlets and Receptacle Testing

NFPA 99 requires routine receptacle testing in patient care areas. Failing to test for polarity, ground integrity, and tension is a frequent deficiency.

What Surveyors Are Looking For

Surveyors typically:

• Review the equipment inventory for completeness.

• Cross-check testing schedules against NFPA 99 standards.

• Ask for recent test logs with pass/fail results and corrective actions.

• Verify that qualified personnel performed the tests.

• Inspect random equipment and outlets to ensure compliance.

CMS guidance explicitly ties PCREE safety to resident protection under the federal Life Safety Code and state-specific regulations.

How to Avoid PCREE Citations

To stay compliant and survey-ready, facilities should:

1. Maintain a Complete Inventory

   • Track every piece of PCREE equipment with serial number, model, and location.

2. Follow a Risk-Based Testing Schedule

   • High-use and high-risk equipment should be tested more frequently than low-use devices.

   • Reference NFPA 99 standards.

3. Document Everything

   • Keep testing logs with test type, date, technician, and results.

   • Store electronically for easy retrieval during surveys.

4. Use Qualified Personnel

   • Partner with biomedical engineers or trained technicians (in-house or third-party).

5. Test Outlets and Receptacles

   • NFPA 99 requires testing for ground resistance, polarity, and mechanical retention.

6. Conduct Internal Audits

   • Review your logs and processes quarterly to catch issues before surveyors do.

Example: A Facility That Got It Right

One skilled nursing facility avoided a major deficiency by adopting a simple checklist:

• Every quarter, the compliance officer reviewed PCREE test logs.

• They worked with a third-party biomedical service to test outlets annually.

• During a CMS survey, inspectors asked for records, and the facility produced organized, up-to-date documentation. Result: Zero deficiencies cited.

Key Takeaways

• Most citations are avoidable. They come from missing documentation or skipped steps, not from complex failures.

• Surveyors expect NFPA 99 compliance and want to see proof of routine testing.

• Proactive programs save money and protect residents.