Appendix PP Revisions in the State Operations Manual: Breaking Down Key Changes

On June 29, the Centers for Medicare & Medicaid Services (CMS) issued a major update to surveyor guidance via Quality, Safety and Oversight (QSO) memo QSO-22-19-NH to strengthen the implementation of the already-in-effect Phases 2 and 3 of the 2016 Reform of Requirements for Long-Term Care Facilities, as well as to update some guidance in response to stakeholder feedback and questions.

The wide-ranging update provides both revised guidance to surveyors (substantive as well as technical revisions) and new guidance to surveyors in the following areas of Appendix PP in the State Operations Manual. 

Revises the following F-tags, particularly to assist surveyors to use PBJ data to identify low staffing concerns for deeper investigation: