The Centers for Medicare & Medicaid Services (CMS) has issued QSO-22-19-NH, which includes new and updated surveyor guidance for the following areas:

• Phase 2 and 3 Requirements: Clarifications and technical corrections of Phase 2 guidance issued in 2017; and new guidance for Phase 3 requirements, which became effective November 28, 2019.
• Arbitration Requirements: Guidance on the new requirements, which became effective September 16, 2019.
• Complaint and Facility Reported Incidents (FRIs): CMS revised the guidance in Chapter 5 and related exhibits of the State Operations Manual (SOM) to strengthen the oversight of nursing home complaints and FRIs. CMS also revised its guidance for all Medicare-certified provider/supplier types to improve consistency across the State agencies in their communication to complainants.
• Psychosocial Outcome Severity Guide: CMS revised guidance to clarify the reasonable person concept and examples across the different severity levels.

CMS has released an advance copy of the Appendix PP, SOM Chapter 5, and the Psychosocial Outcome Severity Guide, and the agency is publicly posting training on these changes for surveyors and the public at the Quality, Safety, and Education Portal.

Surveyors will begin using this guidance to identify non-compliance on October 24, 2022. AHCA has advocated to CMS to give facilities time to review and update existing systems and processes where needed when new guidance is released.

AHCA will review this new and updated guidance in detail over the coming weeks and will share resources to assist members.

More information about the revised guidance can be found on the CMS website.​