CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily. The Nursing Home Compare Web site features a quality rating system that gives each nursing home …
Clarification regarding Nurse Aide Training Competency Evaluation Program (NATCEP) and Nurse Aide Competency Evaluation Program (CEP) requirements and allowable flexibilities Memo # QSO-26-08-NH Posting Date 2026-04-08 Fiscal Year 2026 Memorandum Summary Clarification of NATCEP Requirements and allowable flexibilities: …
As the clinical leader of the largest operational department in a skilled nursing facility, the director of nursing services (DNS), in tandem with the administrator, plays a key role in financial oversight. Ancillary charges are …
The director of nursing services should review ancillary billing monthly to ensure that all billed services and supplies are clinically appropriate, documented accurately, and supported by skilled nursing care. The DNS can use this Ancillary …
Memo # QSO-26-03-NH REVISED Posting Date 2026-04-03 Fiscal Year 2026 Downloads AAPACN note: Some of the key revisions in red from the memo are excerpted below. There are a number of significant changes to the chapters themselves, including …
The Centers for Medicare & Medicaid Services (CMS) is publishing an errata change table document to the Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual v18.0, related to the clarification of details for …
A discharge planning tool to help educate residents and/or representatives about ongoing health and medication needs and follow-up care post-discharge. Nursing Facility Discharge Planning Tool
The Office of Management and Budget (OMB) has approved the control number for the Advance Beneficiary Notice of Non-coverage (ABN) (CMS-R-131). CMS is notifying the industry through our website, and the Medicare Learning Network and …
Report Materials Why OIG Did This Review What OIG Found OIG’s comprehensive review of 40 focused nursing home inspections completed by CMS found alarming instances of inappropriate use of antipsychotic drugs and revealed vulnerabilities in …
Report Materials Why OIG Did This Review What OIG Found OIG’s comprehensive review of 40 nursing home inspections completed by CMS found instances of nursing homes inappropriately diagnosing residents with schizophrenia. Specifically, our review of …
In the Water-related Healthcare Outbreak Response Tool, you will find key considerations for investigating an outbreak and identifying possible exposures, coordinating with essential partners, and implementing targeted interventions to stop transmission. This tool is hospital-focused but …
Overview This job aid provides the steps involved to onboard the Provider Security Official (PSO) Role in iQIES. ● For detailed information on onboarding, refer to iQIES Onboarding Guide. ● For detailed information about user …
Reminder: Upcoming Deadline for Sprinkler System Requirement for Existing Health Care Occupancies in High-Rise Buildings Memo # QSSAM-26-02-ALL Posting Date 2026-03-09 Fiscal Year 2026 Downloads Memorandum Summary • This memorandum is intended to remind CMS-certified …
While the director of nursing services (DNS) and other nurse leaders should keep residents at the heart of every decision, data should provide the framework for those decisions to help residents achieve the best possible …
Emergency Preparedness for Every Emergency Effective Health Care Provider Emergency Planning Sound, timely planning provides the foundation for effective emergency management. The response to an emergency can impact an entire community and can involve numerous medical …
CMS hosted an PBJ Technical informational Call for Software Vendors and Developers on Thursday, February 26, 2026. Please see the attached minutes. Downloads PBJ Tech Call Minutes 02/26/2026 https://qtso.cms.gov/news-and-updates/pbj-technical-information-call-minutes-qas-february-26-2026
The NEW FileSpecVersion 4.10.0 was originally scheduled to be effective on March 22, 2026. The NEW effective date is April 1, 2026. If you submit files using fileSpecVersion 4.10.0 before April 1st, the file will …
Revisions to State Operations Manual (SOM), Appendix R Implementation Date 2026-02-27 CR # N/A Publication # 100-07 Transmittal Year 2026 Downloads Appendix R: Resident Assessment Instrument for Long-Term Care Facilities – Deleted (see Appendix PP …
February 2026 Updates Person-Level – Data Collection Forms and Instructions LTCF Healthcare Personnel Optional Person Level Reporting for Healthcare Personnel (Form 57.217) [PDF – 270 KB]– February 2026 Person-Level – CSV Data Import LTCF Healthcare Personnel …
In today’s regulatory environment, accurate and timely nursing home documentation is more than dutifully recounting what occurred to a resident on a given day. Rather it is a legal record that ideally describes resident care, …
Interdisciplinary wound rounds evaluate the effectiveness, appropriateness, and compliance of wound management. This Wound Rounds Template supports interdisciplinary review, ensures treatments are consistent with physician orders, facility policy, and current standards of practice. It also …
This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP). It is a one-stop shop containing a multitude of reference materials that are provided to the surveyors going …
In late January, the Centers for Medicare & Medicaid Services (CMS) revised the memo QSO-23-01-NH, changing the selection criteria for the Special Focus Facility (SFF) program from staffing to falls. In the memo, CMS noted: …
Surveyors use critical element pathways (CEPs) to work through the steps of their investigation and to determine compliance with several federal regulations. In addition to CEPs, other tools including observational guides are also used to …
The PBJ system has been updated to accept optional hire and termination dates up to 12/31/2050. CMS helpdesk is starting to get tickets regarding this update, so we are following up with clarifications. Please ensure that …
In today’s skilled nursing facility (SNF) landscape, the director of nursing services (DNS) is critical not only in overseeing resident care but also in supporting the organization’s financial stability and regulatory compliance. Both goals require …
Mandates to notify or inform the resident and/or their representative about an array of clinical and service issues are woven throughout the resident rights F-tags and other surveyor guidance in Appendix PP, “Guidance to Surveyors …
PBJ updated the fatal edit -4019 in data specification versions 2.00.0, 2.00.3, and 4.00.0. Previously, optional hire and termination dates could not exceed December 31, 2025. This restriction has been extended to December 31, 2050. …
F641, Accuracy of the Minimum Data Set (MDS), remains one of the most frequently cited F-Tags during surveys, for good reason. The MDS is a critical foundation of resident assessment, care planning, reimbursement, and quality …
Interim final rule with comment period. SUMMARY: This interim final rule with comment period repeals provisions of the final rule titled “Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional …
The Centers for Medicare & Medicaid Services (CMS) has released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) …
F656, Comprehensive Care Plans, is one of the most commonly cited F-tags during survey in nursing homes; however, with intentional processes in place, these citations are largely preventable. A proactive approach to care planning ensures …
The Centers for Medicare & Medicaid Services (CMS) released an updated memo regarding “Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown,” QSO-26-01-ALL Revised, on Oct. 31, 2025. CMS …
Empower the whole team with this quick-reference guide designed to build confidence and readiness for the survey process. Survey 101: What Every Staff Member Should Know provides all team members—from nursing to housekeeping—with a clear, …
Memo # QSO-25-26-NH Posting Date 2025-09-29 Fiscal Year 2025 Memorandum Summary CMS is committed to reinvesting civil money penalty (CMP) funds in projects thatsupport nursing home residents and protect or improve their quality of care and life.Therefore, we …
Issued on 09/15/2025 | Posted on 09/18/2025 | Report number: OEI-05-24-00180 Report Materials Why OIG Did This Review What OIG Found Nursing homes failed to report 43 percent of falls with major injury and hospitalization among Medicare-enrolled residents, as required, in …
Memo # Admin Info-25-11-ALL Posting Date 2025-09-12 Fiscal Year 2025 Summary Memorandum Summary The Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG) remain dedicated to ensuring the health and safety of …
In this LTC DON Chat podcast episode, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, director of education and certification strategy for …
Facility policies serve as the backbone of consistent, safe, and compliant operations. Nursing homes rely on well-developed policies to guide staff, protect residents, and maintain compliance of care delivery that must follow state and federal …
Information on how surveyors currently manage the nursing home survey process: CMS iQIES S&C User Manual: Manage a Survey LTC Facilities v1.2 (Posted 09/03/2025) From https://qtso.cms.gov/software/iqies/reference-manuals
This user manual addresses the processes necessary to perform Survey & Certification (S&C) Electronic Plan of Correction (ePOC) functions in iQIES. CMS iQIES S&C User Manual: ePOC – Provider ePOC Admin Role v1.2 (Posted 07/22/2025) …
The Association for Professionals in Infection Control and Epidemiology (APIC) has released an updated position paper titled “Safe Injection, Infusion, Medication Vial, and Point-of-Care Testing Practices in Health care (2025),” published in the American Journal of Infection Control …
The director of nursing services (DNS) is preparing for her first annual survey. She wants to take a proactive approach regarding facility residents with enteral feedings. However, as a relatively new DNS, she is unsure …
This manual provides general background and information about the submission requirements, such as sample submission screens, submission deadlines, and definitions of job categories. Note: Changes from the previous version of this policy manual are identified …
Release of CMS-2567: Statement of Deficiencies and Plan of Correction Memo # QSO-25-19-All Fiscal Year 2025 Memorandum Summary • CMS is committed to the transparency of quality of care findings, so that patients, residents, and …
Memo # QSO-25-20-NH Posting Date 2025-06-18 Fiscal Year 2025 Memorandum Summary • Post Performance Data for Nursing Home Chains – “Chains” refers to groups of Medicare-certified nursing homes that are connected through common owners, and operators (also …
AHRQ has released an updated Surveys on Patient Safety Culture (SOPS) Nursing Home Survey Version 2.0. This revised survey is designed to help nursing homes assess staff perceptions of resident safety culture in their organizations. The survey …
Medical directors at nursing homes are responsible for implementing resident care policies, coordinating medical care, and participating in quality assessment and assurance activities. Nursing homes are required to report hours worked by medical directors to …
Ensuring that nursing staff have the “appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each …
PRN Medication Use is one of the few sections of the revised F605 (Right to Be Free From Chemical Restraints/Unnecessary Psychotropic Medications) in Appendix PP of the State Operations Manual that does not have changes …
Sensory impairments, such as loss of vision, hearing, taste, smell, or touch, are common among older adults, and significantly affect their quality of life. These impairments often go unnoticed or may be mistaken for cognitive …
As part of their ongoing commitment to ensuring quality care and compliance with federal health and safety regulations, the Centers for Medicare & Medicaid Services’ (CMS) developed an informational provider resource about the survey process. …
The Centers for Medicare & Medicaid Services (CMS) recently confirmed the revisions to the State Operations Manual (SOM), Appendix PP, which went into effect April 28, 2025. The revisions are redlined here. While many revisions …
This workbook simulates the survey functions in iQIES and may provide a bare-bones (i.e., basic) walkthrough of how surveyors will approach survey using iQIES. To access, go to https://qtso.cms.gov/software/iqies/reference-manuals Then go to the section titled iQIES …
In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, director of education and certification strategy for AAPACN, discuss the new …
The director of nursing services (DNS) received a call in the middle of the night that a resident with a diagnosis of dementia had eloped, and it appeared she had been missing for several hours—a …
FFS & MA NOMNC/DENC What’s New 11/18/2024: New NOMNC and DENC for Original Medicare and Medicare Advantage The Office of Management and Budget (OMB) has approved a revised Notice of Medicare Non-Coverage (NOMNC / CMS-10123) …
Written by Kristine Martinez BSN, RN, RAC-CTA, QCP Completing a Minimum Data Set (MDS) correctly is no small task. With approximately 510 answers or choices on a comprehensive MDS (not including CAA investigation), and approximately530 answers …
From https://oig.hhs.gov/compliance/nursing-facility-icpg/ The Nursing Facility ICPG—together with OIG’s General Compliance Program Guidance (GCPG) that applies to all individuals and entities involved in the health care industry—serves as OIG’s updated and centralized source of voluntary compliance program guidance for …
Sepsis—a key driver of hospital readmissions—can have negative clinical impacts for residents and negative financial, quality, survey, and even legal impacts for nursing homes. Here is a review of important basics: What is sepsis? The …
The newly revised Clinical Practice Guideline for Diabetes Management in the Post-Acute and Long-Term Care (PALTC) Setting provides (1) new information on overall goals in diabetes care, (2) detailed information on how to use and …
REVISED: Updates to Nursing Home Care Compare Staffing and Quality Measures Memo # QSO-25-01-NH REVISIONS TO QSO-23-21-NH, ORIGINALLY RELEASED ON September 20, 2023. • Adjustment to Staffing and Quality Measures: CMS will update the staffing …
Compliance with Residents’ Rights Requirement related to Nursing Home Residents’ Right to Vote Memo #QSO-24-21-NH Posting Date 2024-09-26 Fiscal Year 2024 Memorandum Summary• The Centers for Medicare & Medicaid Services (CMS) is affirming the regulatory …
With the help of contractors, CMS revised the SNF ABN, Form CMS-10055, and the form instructions. The SNF ABN form and instructions are located in the download section and are available for immediate use, but …
F-tag 689 (Free of Accident Hazards/Supervision/Devices) was the No. 1 tag cited at the immediate jeopardy (IJ) level in 2023—and remains at the top halfway into 2024, according to QCOR data accessed on June 30, …
Everyone loves a good mystery. Many like to watch their favorite mysteries on television or read a good thriller. However, mystery and suspense should not be a part of the facility assessment review. The final …
Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting; Correction SUMMARY: This document corrects typographical and technical errors in the final rule that appeared in …
Engineering controls can be implemented to isolate people from a hazard and provide protection for long-term care residents and staff. Engineering Controls for Long-Term Care
This site includes access to a provider enrollment and certification roadmap: https://www.cms.gov/medicare/provider-enrollment-and-certification/enroll-as-an-institutional-provider
The NHSN Long-term Care Facility Component supports the nation’s COVID-19 response through the LTCF COVID-19 Module. Facilities eligible to report data to NHSN’s COVID-19 Module include nursing homes/skilled nursing, long-term care for the developmentally disabled, and assisted …
Infection Control Assessment and Response (ICAR) Tool for General Infection Prevention and Control (IPC) Across Settings https://www.cdc.gov/healthcare-associated-infections/php/toolkit/icar.html AT A GLANCE ON THIS PAGE
https://www.cdc.gov/long-term-care-facilities/hcp/training/index.html AT A GLANCE ON THIS PAGE Course link: https://www.train.org/cdctrain/training_plan/3814 Training resources
https://www.cdc.gov/long-term-care-facilities/hcp/prevent-mdro/faqs.html AT A GLANCE Frequently asked questions about using enhanced barrier precautions in nursing homes to prevent MDROs. ON THIS PAGE
https://www.cdc.gov/long-term-care-facilities/hcp/prevent-mdro/PPE.html KEY POINTS How to implement personal protective equipment (PPE) use in nursing homes to prevent spread of multi-drug resistant organisms (MDROs). Summary of recent changes Enhanced Barrier Precautions in Nursing Homes – Video, Posters, …
AGENCY: Office for Civil Rights, Office of the Secretary, Department of Health and Human Services; Centers for Medicare & Medicaid Services, Department of Health and Human Services. ACTION: Final rule and interpretation. SUMMARY: The Department …
The Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting final rule adopts the Centers for Medicare & Medicaid Services’ (CMS) proposed three-pronged, comprehensive staffing approach for Medicare- and Medicaid-certified …
When an abuse situation occurs, staff must know how to respond and must do so in a timely manner. Opportunities to practice enable staff to sharpen their responses to these events. AAPACN’s Mock Abuse Drill …
Nursing homes are required to establish a surveillance system (i.e., “the routine, ongoing, and systematic collection, analysis, interpretation, and dissemination of surveillance data”) as part of their infection prevention and control program (IPCP) under F-tag …
The expedited determination beneficiary notification process covers a lot of ground in skilled nursing facilities (SNFs), affecting residents in the fee-for-service (FFS) Medicare Part A program and Medicare Advantage plans, as well as residents who …
In the Jan. 18, 2023, Quality, Safety, and Oversight (QSO) memo QSO-23-05-NH, the Centers for Medicare & Medicaid Services (CMS) announced plans to conduct offsite audits to assess whether nursing homes appropriately assess, document, and …
The GCPG is a reference guide for the health care compliance community and other health care stakeholders. The GCPG provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other items useful for understanding health …
Over the past few years, the Centers for Medicare & Medicaid Services (CMS) has placed increasing emphasis on drug regimen review (DRR) aka medication regimen review (MRR). Since 2018, skilled nursing facilities have captured one …
Admissions are vital to a facility. They may occur daily, or even multiple times a day, and should be a part of routine operations. However, the admission process can be cumbersome, and it is easy …
The admission process can be lengthy, and staff can miss important details. Use the Medical Record Audit: New Admission/Readmission checklist to ensure the facility has obtained critical information from newly admitted and readmitted residents and …
Memo # QSO-23-23-NHs Posting Date 2023-09-25 Fiscal Year 2023 Title Memorandum Summary CMS is committed to reinvesting civil money penalty (CMP) funds for projects to support the quality of care and life for nursing home …
In the long-awaited Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule, the Centers for Medicare & Medicaid Services (CMS) proposes a three-pronged, comprehensive staffing approach for Medicare- …
In February 2022, the Biden-Harris Administration announced a comprehensive set of reforms aimed at improving quality and safety for residents in nursing homes. One aspect of this initiative was conducting a new Nursing Home Staffing …
F740 (Behavioral Health Services) is not a frequently cited F-tag so far in calendar year (CY) 2023, according to QCOR data posted on Aug. 13, 2023. However, the consequences can be severe—surveyors often issue this …
The use of psychotropic medications in the skilled nursing facility (SNF) is a controversial issue with implications for resident, regulatory, and financial outcomes. The many requirements can be confusing, especially for a relatively new director …
Nursing homes face significant risk and liability under F-tag 609 (Reporting of Alleged Violations), says Janet Feldkamp, RN, BSN, LNHA, CHC, JD, a partner in the Benesch Healthcare + Practice Group at Benesch, Friedlander, Coplan …
Memo # QSO-23-18-NH Posting Date 2023-06-28 Fiscal Year 2023 Memorandum Summary • Posting Nursing Home Affiliation on Nursing Home Care Compare: CMS will include ownership and operatorship affiliation information on our Nursing Home Care Compare …
The director of nursing services (DNS) position is multi-faceted, and a new DNS must learn a lot quickly. Areas such as providing residents quality care and staffing take top priority, and rightfully so. However, another …
