CMS Releases Updated SOM Appendix PP Guidance to Surveyors

This week, the Centers for Medicare & Medicaid Services (CMS) released the update version of the State Operations Manual. Revisions to Appendix PP – Guidance to Surveyors for Long Term Care Facilities have been updated to reflect CMS S&C letters that have been issued from 2003-2014.

Regulations that have been updated include F-tags with major revisions, including F-155, to minor additions to guidance to help surveyors in determining compliance. Updated F-tags include:

  • F-155 Right to Refuse; Formulate Advance Directives
  • F-161 Surety Bond – Security of Personal Funds
  • F-202 Documentation for Transfer/Discharge of Res
  • F-208 Prohibiting Certain Admission Policies
  • F-222 Right to be Free from Chemical Restraints
  • F-278 Accuracy of Assessment/Coordination/Certified
  • F-281 Services Provided Meet Professional Standards
  • F-286 Maintain 15 Months of Resident Assessments
  • F-309 Provide Care/Services for Highest Well Being
  • F-322 NG Treatment/Services – Restore Eating Skills
  • F-329 Drug Regimen is Free From Unnecessary Drugs
  • F-332 Free of Medication Error Rates of 5% or More
  • F-333 Residents are Free of Significant Med Errors
  • F-371 Food Procurement, Store/Prepare/Serve – Sanitary
  • F-388 Personal Visits by Physician, Alternate PA/NP
  • F-390 Physician Delegation of Tasks in SNFs & NFs
  • F-425 Pharmaceutical Svc – Accurate Procedures, RPH
  • F-428 Drug Regimen Review, Report Irregular, Act On
  • F-431 Drug Records, Label/Store Drugs & Biologicals
  • F-441 Infection Control
  • F-492 Comply With Federal/State/Local Laws/Prof Std
  • F-514 Resident Records – Complete/Accurate/Accessible
  • F-516 Release Resident Info, Safeguard Clinical Records

It’s interesting to note that several of the updates regulations are part of the top ten most cited deficiencies in the United States for 2014, including F-441 (#2), F-371 (#3), F-309 (#5), F-329 (#6), F-431 (#7) and F-514 (#10). This means that surveyors are already well-tuned into these potential trouble areas of your facility, so they are worth taking a look at to review your facility’s systems to ensure you are in compliance.

View the updated Surveyor Guidance on the CMS website.

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