Hot off the presses — In a new QSO Memo dated February 2, 2026 (despite today being January 30, 2026), the Centers for Medicare & Medicaid Services (CMS) issued updated guidance. The Memo, “Revisions to State Operations Manual (SOM) Chapters 5 and 7” addresses guidance for Chapter 5 related to Immediate Jeopardy and Chapter 7 regarding a plethora of survey-related items. Guidance from Appendix P was moved to Chapter 7.
Memorandum Summary
CMS is releasing the following guidance in Chapter 5 of the SOM:
- Revisions to Immediate Jeopardy Priority Definition examples for Nursing Homes; and
- Clarification of Off-site investigations.
CMS has updated and revised guidance in Chapter 7 of the SOM that includes:
- Survey Team Composition, Survey Procedures, Plans of Correction, Verifying Corrections, Survey Revisit and Offsite Revisit Paper Review, Off-hours Survey, Enforcement, Nurse Staffing Waivers, Disposition of Civil Money Penalties (CMP), Federal Civil Penalties Inflation Reduction Act, Informal Dispute Resolution (IDR), and Independent Informal Dispute Resolution (IIDR);
- Additionally, guidance previously found in Appendix P of the State Operations Manual has been added to Chapter 7; and
- Technical changes that include updates for accurate references.
These changes are effective March 30, 2026. View the revisions in QSO-26-03-NH here and check back shortly to the CMSCG Blog for key information. Want to receive updates direct to your inbox? Register here.
