Consistent adherence to nursing home regulations is crucial for ensuring resident safety and well-being. In this blog, we overview of CMS Nursing Home Regulations F770-779, which cover laboratory and diagnostic services. We’ll delve into the key compliance elements and share best practices to help you excel in this area.

Overview of the Regulations

F770 Laboratory Services:

  • Nursing homes must provide timely and accurate laboratory services.
  • Compliance includes having the right Clinical Laboratory Improvement Amendment (CLIA) certificate.

F771 Blood Bank and Transfusion Services:

      • Nursing homes providing these services must meet applicable requirements.
      • Ensure the quality and timeliness of services.

F772 Lab Services Not Provided On-Site:

      • Facilities must have agreements for off-site lab services that meet requirements.

F773 Lab Services Physician Order/Notify of Results:

      • Timely communication between physicians and lab services is essential.
      • Ensure lab tests are ordered as needed and results are promptly reported.

F774 & F778 Assist with Transport Arrangements:

      • Assist residents in transportation for off-site lab and radiology services.

F775 & F779 Lab Reports and Diagnostic Reports:

      • Maintain comprehensive and dated records in resident clinical files.

F776 Radiology and Other Diagnostic Services:

      • Quality and timely radiology and diagnostic services are vital.
      • Compliance includes having a written agreement for these services.

F777 Radiology and Other Diagnostic Services:

      • Only provide or obtain services when ordered by qualified healthcare professionals.
      • Promptly notify these professionals of results falling outside clinical reference ranges.


Best Practices for Compliance

Best practices to achieve and maintain compliance with these regulations include:

  1. Develop Clear Policies and Procedures:
      • Create detailed policies and procedures outlining the protocols for laboratory and diagnostic services.
      • Clearly define roles and responsibilities of staff involved in ordering, conducting, and documenting lab tests.
  1. Staff Training and Education:
      • Provide regular training to staff members regarding the importance of compliance with regulations.
      • Educate staff on recognizing high-risk medications and the significance of accurate lab results in medication management.
  1. Robust Communication Protocols:
      • Establish efficient communication channels between physicians, laboratory services, and nursing home staff.
      • Implement electronic health record (EHR) systems to facilitate seamless sharing of lab results and diagnostic reports.
  1. Continuous Quality Monitoring:
      • Conduct regular internal audits to ensure compliance with regulations.
      • Implement a continuous quality improvement program to identify areas for enhancement and address any compliance issues promptly.
  1. Collaboration with External Providers:
      • Foster strong partnerships with external laboratories and diagnostic service providers.
      • Maintain open lines of communication to facilitate quick and accurate exchange of information.
  1. Proper Documentation and Record-Keeping:
      • Implement standardized documentation processes to record lab orders, results, and diagnostic reports.
      • Ensure all records are complete, accurate, signed, dated, and easily accessible for review.
  1. Regular Staff Meetings and Training Sessions:
      • Conduct regular staff meetings to discuss compliance updates and address any concerns or challenges faced by the staff.
      • Organize training sessions and workshops focusing on adherence to regulations and best practices in laboratory services.
  1. Incident Reporting and Root Cause Analysis:
      • Implement a robust incident reporting system to capture any deviations from established protocols.
      • Conduct thorough root cause analyses for incidents to identify underlying issues and prevent future occurrences.
  1. Engage Residents and Families:
      • Involve residents and their families in the care planning process, ensuring they are informed about lab tests and their significance.
      • Encourage open communication, addressing any questions or concerns raised by residents or their families promptly.
  1. Stay Updated with Regulatory Changes:
      • Assign a dedicated staff member or team to stay updated with CMS regulations and guidelines.
      • Implement changes promptly as new regulations are introduced, ensuring ongoing compliance.


By integrating these best practices into daily operations, nursing homes can create a culture of compliance, emphasizing the importance of accurate laboratory services and diagnostic reporting. This proactive approach not only ensures adherence to regulations but also enhances the overall quality of care provided to residents, promoting their health, safety, and well-being. Access on-demand training to Proactive’s Deep Dive Laboratory, Radiology and Other Diagnostic Services in the Proactive Shop.


Angie Hamer, RN, RAC-CT
Clinical Consultant

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