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Conditions of Participation (CoPs)
Conditions for Coverage (CfCs)
Citations
Advance Directives| Current Requirements | 42 CFR 489.102 §4002(d) of the BBA 97 |
| Definitions | 42 CFR 489.100 |
Ambulatory Surgical Services
| Current Conditions |
42 CFR 416.40-416.49 §1832(a)(2)(F)(i) of the Act §1833(i)(1)(A) of the Act |
| Definitions | 42 CFR 416.2 |
| Interpretive Guidelines | Appendix L of the SOM (PDF, 263 kb) |
Anesthesia Supervision (CRNAs)
| Current Conditions | FR Final Rule (11/13/01) |
| Opt-Out States | Effective Dates |
Comprehensive Outpatient Rehabilitation Facilities
| Current Conditions | 42 CFR 485.50-485.74 |
| Definitions |
42 CFR 485.51 §1861(cc) of the Act |
| Interpretive Guidelines | Appendix K of the SOM (PDF, 202 kb) |
Critical Access Hospitals
| Current Conditions |
42 CFR 485.601-485.645 §1820 of the Act |
| Current Conditions for Emergency Services |
FR Final Rule (12/31/02) pgs 80041-42 |
| Definitions |
42 CFR 485.602 §1861(mm) of the Act |
| Interpretive Guidelines | Appendix W of the SOM (PDF, 1.6 mb) |
Diabetes Self-Management Training
| Accreditation for ADA | FR Notice (10/26/01) |
| Accreditation for IHS | FR Final Notice (3/22/02) |
| Current Conditions |
FR Final Rule (12/29/00)
§4105 of the BBA 97 42 CFR 410.140-410.146 |
| Definitions |
§1861(qq) of the Act 42 CFR 410.140 |
End Stage Renal Disease Services
| Current Conditions |
42 CFR 405.2100-405.2184 §§1881(b)(1) & (c) of the Act |
| Definitions | 42 CFR 405.2102 |
| Interpretive Guidelines | Appendix H of the SOM (PDF, 1.7 mb) |
Home Health Services
| Current Conditions |
42 CFR 484.10-484.20 42 CFR 484.30-484.55 §1891 of the Act |
| Current Conditions for OASIS |
FR Final Rule (01/25/99) Home Page |
| Definitions |
42 CFR 484.2 §1861(m) of the Act §1861(o) of the Act |
| Interpretive Guidelines | Appendix B of the SOM (PDF, 761 kb) |
| Proposed Conditions | FR Proposed Rule (3/10/97) |
Hospice Care
| Current Conditions |
42 CFR 418.50-418.74 42 CFR 418.80-418.88 42 CFR 418.90-418.100 |
| Definitions | 42 CFR 418.3 §1861(dd) of the Act |
| Interpretive Guidelines | Appendix M of the SOM (PDF, 720.kb) |
Hospitals
| Current Conditions |
42 CFR 482.11-482.13 42 CFR 482.21-482.45 42 CFR 482.51-482.57 |
| Current Conditions for Organ Procurement |
Home Page |
| Current Conditions for Patients' Rights |
Home Page |
| Current Conditions for QAPI |
FR Final Rule (1/24/03) |
| Current Conditions for Swing Beds |
42 CFR 482.66 §1883 of the Act |
| Definitions |
§1861(b) of the Act §1861(e) of the Act |
| Interpretive Guidelines | Appendix A of the SOM (PDF, 2.2 mb) |
| Interpretive Guidelines for Swing Beds |
Appendix T of the SOM (PDF, 363 kb) |
| Proposed Conditions | FR Proposed Rule (12/19/97) |
| Proposed Conditions for Laboratory Services (Hepatitis-C Virus Look Back) |
FR Proposed Rule (11/16/00) |
Immunization Standards for Hospitals, Long-Term Care Facilities, and HHAs
| Current Conditions | FR Final Rule (10/02/02) |
| Influenza/Pneumococcal Vaccination Campaign |
Home Page |
Intermediate Care Facilities for the Mentally Retarded
| Current Conditions | 42 CFR 483.400-483.480 |
| Definitions | §1905(d) of the Act |
| Interpretive Guidelines | Appendix J of the SOM (PDF, 1.8 mb) |
Life Safety Code
| Current Conditions | FR Final Rule (1/10/03) |
| Interpretive Guidelines | Appendix I of the SOM (PDF, 140 kb) |
| Proposed Conditions | FR Proposed Rule (10/26/01) |
Long Term Care Facilities
| Current Conditions |
42 CFR 483.1-483.75 §1819 of the Act §1919 of the Act |
| Current Conditions for NH Feeding Assistant |
FR Final Rule (9/26/03) |
| Definitions |
42 CFR 483.5 §1819(a) of the Act §1919(a) of the Act |
| Interpretive Guidelines | Appendix PP of the SOM (PDF, 2.4 mb) |
Managed Care
| Current Conditions |
42 CFR 417.400-417.418 §1876 of the Act |
| Definitions |
42 CFR 417.1 42 CFR 417.401 |
Medical Nutrition Therapy
| Current Conditions |
42 CFR 410.130-410.134 §1861(s)(2) of the Act §1833(a)(1) of the Act |
| Definitions | 42 CFR 410.130 |
Medicare+Choice
| Current Conditions | FR Final Rule
p1,
p2,
p3,
p4 (06/29/00) §1852(e) of the Act 42 CFR 422.100-422.132 42 CFR 422.152-422.158 |
| Definitions | 42 CFR 422.2 |
Organ Donation and Transplantation
| Current Requirements for Heart Transplants |
National Coverage Determination FR Notice (4/06/87) (PDF, 1.6 MB) |
| Current Requirements for Intestinal/Multivisceral Transplants |
National Coverage Determination |
| Current Conditions for Kidney Transplants |
42 CFR 405.2102, 405.2120-405.2124, 405.2130, 405.2131, 405.2136g, 405.2170, 405.2171 |
| Current Requirements for Liver Transplants (Adult) |
FR Notice (4/12/91) (PDF, 1.1 MB) National Coverage Determination |
| Current Requirements for Liver Transplants (Pediatric) |
National Coverage Determination |
| Current Requirements for Lung/Heart-Lung Transplants |
FR Notice (2/02/95) |
| Current Requirements for Pancreas Transplants |
National Coverage Determination |
| Current Requirements for Transplant Centers |
Decision Memorandum (7/26/00) |
| Current Hospital Conditions for Organ Procurement |
Home Page |
| Current Social Security Act Requirements | §1138 of the Act |
| Current PHS Act Requirements | 42 USC Chapter 6A Subchapter II Part H |
Outpatient Physical Therapy
| Current Conditions |
42 CFR 485.701-485.729 42 CFR 486.150-486.163 |
| Definitions |
42 CFR 485.703 §1861(p) of the Act |
| Interpretive Guidelines | Appendix E of the SOM (PDF, 234 kb) |
Patient Dumping (EMTALA)
| Clarifying Policies | FR Final Rule (9/09/03) |
| Current Responsibilities |
42 CFR 489.20 42 CFR 489.24 |
| Definitions | 42 CFR 489.24(b) |
| Interpretive Guidelines | Appendix V of the SOM (PDF, 393.kb) |
Programs of All-Inclusive Care for the Elderly
| Current Requirements |
FR Interim Final Rule (11/24/99) §1934 of the Act 42 CFR 460.60-460.82 42 CFR 460.90-460.106 42 CFR 460.110-460.124 42 CFR 460.130-460.140 |
| Definitions |
42 CFR 460.6 §1894 of the Act |
Psychiatric Hospitals and Units
| Current Conditions | 42 CFR 482.60-482.62 |
| Current PPS Exclusions | 42 CFR 412.20, 412.22, 412.23(a), 412.25, 412.27 |
| Definitions | §1861(f) of the Act |
| Interpretive Guidelines | Appendix AA of the SOM (PDF, 606 kb) |
Rehabilitation Hospitals and Units
| Current Conditions | 42 CFR 482.56 |
| Current PPS Exclusions | 42 CFR 412.20, 412.22, 412.23(b), 412.25, 412.29, 412.30 |
| Interpretive Guidelines | Appendix A of the SOM (PDF, 2.2 mb) |
Religious Nonmedical Health Care Institutions
| Current Conditions | 42 CFR 403.730-403.746 |
| Definitions |
42 CFR 403.702 §1861(y) of the Act |
| Interpretive Guidelines | Appendix U of the SOM (PDF, 452 kb) |
Rural Health Clinics/Federally Qualified Health Centers
| Current Conditions | 42 CFR 491.1-491.11 |
| Proposed Conditions for QAPI |
FR Proposed Rule (02/28/00) §4205(b) of the BBA 97 |
| Definitions |
42 CFR 491.2 §1861(aa) of the Act |
| Interpretive Guidelines | Appendix G of the SOM (PDF, 382 kb) |
Act = Social Security Act
ASCs = Ambulatory Surgical Centers
ADA = American Diabetes Association
BBA = Balanced Budget Act
CFR = Code of Federal Regulations
CRNA = Certified Registered Nurse Anesthetists
DSMTS = Diabetes Self-Management Training Services
EMTALA = Emergency Medical Treatment and Labor Act
FR = Federal Register
HHAs = Home Health Agencies
IHS = Indian Health Service
OPOs = Organ Procurement Organizations
NH = Nursing Home
OASIS = Outcome and Assessment Information Set
PHS = Public Health Service
PPS = Prospective Payment System
QAPI = Quality Assessment and Performance Improvement
SOM = State Operations Manual
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Last Modified on Tuesday, October 05, 2004
Centers for Medicare & Medicaid Services