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CMS Guidance to State Survey Agency Directors and CMS Regional Offices


As they become available, CMS memoranda, letters and instructions to State Survey Agency Directors and CMS Regional Offices will be posted by category.


Title Number Date
Fiscal Year 2004
Implementation of Critical Access Hospital (CAH) Distinct Part Units (DPUs) for Psychiatric and Rehabilitation Services (S&C 04-48) - PDF 94KB #48 09/29/04
FY 2004 State Performance Review Protocol Guidance (S&C 04-47) - PDF 692KB; Attachment 4, Excel Zip 7KB #47 09/9/04
Electronic Signature Guidance (S&C 04-46) - PDF 66KB #46 09/9/04
Home Health Agencies (HHAs): Clarification of Timing Requirements For Conducting The Comprehensive Assessment On Pediatric And Maternity Patients As Well As Those Patients Receiving Personal Care Services Only (S&C 04-45) - PDF 63KB #45 09/9/04
Availability and Implementation of the Pharmaceutical and Herbal Products Database (S&C 04-44) - PDF 75KB #44 09/9/04
Final Adjustment in Implementation Date - October 1, 2004 - National Transition Date for the Automated Survey Processing Environment (ASPEN) Enforcement Manager (AEM) for Nursing Homes (S&C 04-43) - PDF 139KB #43 08/12/04
Status of the December 24, 2003 Final Rule: Rural Health Clinics (S&C 04-42) - PDF 52KB #42 08/12/04
Corridor Width & Corridor Mounted Computer Touch Screens in Health Care Facilities - Clarification Effective Immediately (S&C 04-41) - PDF 57KB #41 08/12/04
Resident Assessment Instrument (RAI) Training Program (S&C 04-40) - PDF 60KB #40 08/12/04
Clinical Laboratory Improvement Amendments (CLIA) State Agency Performance Review (SAPR)-Fiscal Year 2004 (FY2004) (S&C 04-39) - PDF 173KB #39 08/12/04
Additional Language Required In Initial Notice To Nursing Homes (S&C 04-38) - PDF 63KB #38 08/12/04
Addendum 1 S&C Letter 04-24 on the Care for Residents of Long-Term (LTC) Facilities Who Receive End Stage Renal Disease (ESRD) Services (S&C 04-) - PDF 76KB #37 07/08/04
Corrections to Appendix H of the State Operations Manual (SOM) Web Version (S&C 04-36) - PDF 68KB #36 07/08/04
Physicians Rubber Stamp Signature (S&C 04-35) - PDF 63KB #35 07/08/04
Revised Emergency Medical Treatment and Labor Act (EMTALA) Interpretive Guidelines (S&C 04-34) - PDF 408KB #34 05/13/04
Life Safety Code (LSC) and State Performance Standards (S&C 04-33) - PDF 76KB #33 05/13/04
Rollout of New Surveyor Aptitude Test and In-Service Training Guide (S&C 04-32) - PDF 703KB #32 05/13/04
Status of Form CMS-1514 (S&C 04-31) - PDF 213KB #31 05/13/04
Clarification of the Scoring for Measure 5 (Medication Investigation) of the Federal Oversight Support Survey (FOSS) Protocol for Long Term Care (LTC) (S&C 04-30) - PDF 57KB #30 05/13/04
Life Safety Code (LSC) Surveyor Reference Materials (S&C 04-29) - PDF 64KB #29 05/13/04
Pilot Program for the Pharmaceutical and Herbal Products Database-Part 2 (S&C 04-28) - PDF 81KB #28 05/13/04
Opening of New Centers for Medicare & Medicaid Services (CMS) Web Site Resource for long Term Care (LTC) Surveyors and Providers (S&C 04-27) - PDF 57KB #27 05/13/04
Clarification of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003 for Non-Medicare/Non-Medicaid Patients in Home Health Agencies (HHAs) (S&C 04-26) - PDF 76KB #26 04/08/04
Upcoming Criminal Background Checks Pilot (S&C 04-25) - PDF 71KB #25 04/08/04
Clarifiction of Certification Requirements and Coordination of Care for Residents of Long-Term Care (LTC) Facilities Who Receive End Stage Renal Disease (ESRD) Services (S&C 04-24) - PDF 561KB #24 03/11/04
Procedures in the Event of a Fire in a Medicare- or Medicaid-Certified Health Care Facility (S&C 04-23) - PDF 121KB #23 03/11/04
Overnight Stays in Ambulatory Surgical Centers - Clarification Effective Immediately (S&C 04-22) - PDF 105KB #22 03/11/04
Impact of Section 946 of the Medicare of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) on the Hospice Core Services Requirement (S&C 04-21) - PDF 110KB #21 02/12/04
Resource Materials for Death Reporting in Psychiatric Residential Treatment Facilities (PRTFs) (S&C 04-20) - PDF 100KB; List of PRTFs by State within each Region Excel Zip 28K #20 02/12/04
Calendar Year 2004 Revised Release Schedule for Automated Survey Processing Environment (ASPEN) Software (S&C 04-19) - PDF 120KB #19 02/12/04
Impact of the Health Insurance Portiability and Accountability Act (HIPPA) on the Nursing Home Requirements for Posting Survey Results - Clarification (S&C 04-18) - PDF 136KB #18 02/12/04
Clarification on Nursing Homes Requiring Promissory Notes or Deposit of Fees as a Condition of Admission and Implications Related to Surety Bonds (S&C 04-17) - PDF 149KB #17 01/08/04
Clinical Laboratory Improvement Amendments(CLIA) Policy and Data Reporting Guidance for First Survey Cycle Following the Effective Date of CMS-2226-F (S&C 04-16) - PDF 1.6MB; Attachment E - Excel Zip 4KB #16 01/08/04
Definitions of Terms Used in the Life Safety Code (LSC) of the National Fire Protection Association (NFPA) (S&C 04-15) - PDF 62KB #15 12/11/03
Implementation of Critical Access Hospital Bed Size Increase (S&C 04-14) - PDF 58KB #14 12/11/03
Use of Restraints and Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services to Individuals Under 21 (S&C 04-13) - PDF 549KB #13 12/11/03
The Collection and Transmission of the Outcome and Assessment Information Set (OASIS) Data for Private Pay Patients (non-medicare/non-Medicaid) (S&C 04-12) - PDF 83KB #12 12/11/03
State Survey Agency Performance Standards for Fiscal Year (FY) 2004 (S&C 04-11) - PDF 573KB #11 11/19/03
Emergency Medical Treatment and Labor Act (EMTALA) Interim Guidance (S&C 04-10) - PDF 87KB #10 11/07/03
Guidelines to Support Management of Complaints and Incidents and the National Implementation of the ASPEN Complaints/Incidents Tracking System (ACTS) (S&C 04-09) - PDF 543KB #9 11/13/03
Physician Delegation of Tasks in Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs) (S&C 04-08) - PDF 68KB #8 11/13/03
Minimum System Requirements (S&C 04-07) - PDF 84KB #7 11/13/03
Definition of "Significant Difference" for Federal Oversight Support Survey (FOSS) and Long Term Care (LTC) Comparative Surveys (S&C 04-06) - PDF 59KB #6 11/13/03
Guidance On Test Systems That Are Categorized as Either Waived or Moderate Complexity Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) (S&C 04-05) - PDF 79KB #5 11/13/03
Comparative Surveys for Fiscal Year 2004 (S&C 04-04) - PDF 105KB #4 10/09/03
Input Instructions for Comparative Surveys for FY 2004 Policy and Database Clarification (S&C 04-03) - PDF 108KB #3 10/09/03
Use of Mapping to Determine Rural Eligibility for Rural Health Clinics (S&C 04-02) - PDF 104KB #2 10/09/03
Mandatory On-Line Prerequisities for Basic Long Term Care Training (S&C 04-01) - PDF 114KB #1 10/09/03
Fiscal Year 2003
Correction Policy for Home Health Agency (HHA) Administrative Data on the Home Health Compare Web Site (S&C 03-33) - PDF 106KB #33 09/11/03
Pilot Program for Surveyor Technical Assistant for Renal Disease (STAR) (S&C 03-32) - PDF 114KB #32 08/14/03
Transfer of Data from the ASPEN Complaints/Incident Tracking System (ACTS) to State Systems - Decision (S&C 03-31) - PDF 121KB #31 08/14/03
Clinical Laboratory Improvement Amendments (CLIA) Policy Letters for First Survey Cycle Following the Effective Date of CMS-2226-F (S&C 03-30) - PDF 149KB #30 08/14/03
Discontinuance of Forms HCFA-1513, "Ownership and Control Interest Disclosure Statement" and HCFA-2572, "Statement of Financial Solvency" (S&C 03-29) - PDF 98KB #29 08/14/03
Automation of Surveyor Minimum Qualifications Test (SMTQ)and Clarification of Survey Activities (S&C 03-28) - PDF 133KB #28 07/10/03
State Survey Agency Performance Standards for Fiscal Year (FY) 2003 (S&C 03-27) - PDF 1.2MB #27 07/10/03
Impact of the Health Insurance Portability and Accountability Act (HIPAA) on the Nursing Home Requirement for Posting Survey Results (S&C 03-26) - PDF 94KB #26 06/12/03
Clarification of Issues Related to Informal Dispute Resolution (S&C 03-25) - PDF 96KB #25 06/12/03
Long Term Care Medication Pass Survey Requirement Clarification (S&C 03-24) - PDF 105KB #24 06/12/03
Clarification of Designation of "Distinct Part" in the State Operations Manual (Pub. 7) (S&C 03-23) - PDF 88KB #23 06/12/03
Clarification of CMS Payment Policies Regarding Ambulatory Surgical Centers/Independent Diagnostic Testing Facilities Conducting Business From the Same Location (S&C 03-22) - PDF 92KB #22 06/12/03
Adoption of New Fire Safety Requirements for RNHCIs, ASCs, Hospice, PACE, Hospitals, Long Term Care, ICFs/MR, and CAHs (S&C 03-21) - PDF 283KB #21 05/08/03
Medicare Identification Number Assignment for End Stage Renal Dialysis (ESRD) Facilities (S&C 03-20) - PDF 112KB #20 05/08/03
Policy for Interim Period Between the Effective Date of CMS-226-F and Publication of Surveyor Guidelines (S&C 03-19) - PDF 1.2MB #19 05/08/03
Personnel Provisions of the Critical Access Hospital Emergency Services Requirement for Frontier Areas and Remote Locations (S&C 03-17) - PDF 246KB #17 04/10/03
Interim Guidance for the Hospital Quality Assesment and Performance Improvement Condition of Participation (S&C 03-16) - PDF 112KB #16 04/10/03
Review of Protected Health Information and Applicability of Business Associate Agreements Under the Health Insurance Portability and Accountability Act (HIPAA) for the Purposes of Survey and Certification (S&C 03-15) - PDF 110KB #15 03/14/03
Clarification of Instructions for form CMS-671, Long Term Care Facility Application for Medicare and Medicaid (S&C 03-14) - PDF 48KB
Attachment - PDF 572KB
#14 02/13/03
Home Health Survey Protocol Enhancements (S&C 03-13) - PDF 993KB #13 02/13/03
Coordinated Survey Approach For Critical Access Hospitals Having Multiple Affiliated Providers - (S&C 03-12) - PDF 58KB #12 02/13/03
BIPA 941 Nursing Home Requirement Effective January 1, 2003; Follow-up to S&C-03-03 Memorandum of October 10, 2002 - ACTION (S&C 03-11) - PDF 100KB #11 01/09/03
Binding Arbitration in Nursing Homes (S&C 03-10) - PDF 101KB #10 01/09/03
Revised Resident Assessment Instrument User's Manual Release Effective January 1, 2003 (S&C 03-09) - PDF 82KB #9 01/09/03
Information Exchange by Surveyors During the Nursing Home Survey Process (S&C 03-08) - PDF 45KB #8 12/12/02
CLIA State Agency Performance Review (SAPR) - Introductory Version for Fiscal Year 2003 (S&C 03-07) - PDF 220KB
Excel Spreadsheet Attachment (sc0307.zip) 14KB
#7 12/12/02
Conversion of Surveyor Minimum Qualifications Test (SMQT) from a Two-Day Test to a One-Day Test (S&C 03-06) - PDF 43KB #6 12/12/02
Fiscal Year (FY) 2003 Training Requirements for End Stage Renal Disease (ESRD), Home Health Agency (HHA), Hospice and Intermediate Care Facility for the Mentally Retarded (ICF/MR) Surveyors (S&C 03-05) - PDF 111KB #5 11/14/02
Interim Guidance to Support National Pilot of the ASPEN Complaints/Incidents Tracking System (ACTS) (S&C 03-04) - PDF 130KB #4 11/8/02
BIPA 941 Nursing Home Requirement Effective January 1, 2003 (S&C 03-03) - PDF 112KB #3 10/10/02
Change in Requirement for Signed Physician's Order for Flu and Pneumonia Vaccine (S&C 03-02) - PDF 86KB #2 10/10/02
Policy and Procedures for Conducting the Federal Comparative Survey, FY 2003 (S&C 03-01) - PDF 236KB #1 10/10/02
Fiscal Year 2002
Comparative Surveys for Fiscal Year 2003 (S&C 02-45) - PDF 29KB #45 09/12/02
Impact of Nursing Shortage on Hospice Care (S&C 02-44) - PDF 34KB #44 09/12/02
Centers for Disease Control and Prevention (CDC) Revised Recommendations for Single-Use Intravenous Medication Vials in End Stage Renal Disease (ESRD) Facilities (S&C 02-43) - PDF 115KB #43 09/12/02
Use of Civil Money Penalty (CMP) Funds by States (S&C 02-42) - PDF 99KB #42 08/08/02
Proposed Changes to the Outcome and Assesement Information Set (OASIS) (S&C 02-41) - PDF 163KB #41 08/08/02
Fiscal Year (FY) 2003 State Survey and Certification Budget Call Letter (S&C 02-40) - PDF 715KB #40 07/02/02
Nursing Home That Has No Arrangement to Provide Dialysis Services To Its Residents (S&C 02-39) - PDF 97KB #39 08/08/02
Final Guidance Package for Clinical Laboratory Improvement Amendments of 1998 Federal Monitoring Survey Process (S&C 02-38) - PDF 231KB #38 08/08/02
Assigning Provider Identification Numbers to Home Health Agency Branches (S&C 02-37) - PDF 125KB #37 08/08/02
Privacy of Medical Record Information in Rural Health Clinics (S&C 02-36) - PDF 85KB #36 08/08/02
Simultaneously On-Call (S&C 02-35) - PDF 96KB #35 06/13/02
On-Call Requirements-EMTALA (S&C 02-34) - PDF 228KB #34 06/13/02
Interim Guidance to Support Information of the ASPEN Complaints/Incidents Tracking System (ACTS) (S&C 02-33) - PDF 108KB #33 06/06/02
Resident Assessment Instrument Coordinator Responsibilities in Minimum Data Training of Swing Bed Hospital Staff (S&C 02-32) - PDF 1,560KB #32 06/06/02
Mandatory Viewing of Satellite and Webcast Training Program (S&C 02-31) - PDF 99KB #31 05/10/02
Requests for Home Health Agency Branch Office Approval and the Use of a Reciprocal Agreement (S&C 02-30) - PDF 182KB #30 05/10/02
Promising Practices for Implementing the Medicare Hospice Benefit for Nursing Home (NH) Resident (S&C 02-29) - PDF 127KB #29 05/10/02
State Agency Performance Standards for Fiscal Year (FY) 2002 - Revised (S&C 02-28) - PDF 234KB #28 04/29/02
Update to Data Posted on Nursing Home Compare Website (S&C 02-27) - PDF 171KB #27 04/29/02
Intermediate Care Facilities for Persons with Mental Retardation (ICFs/MR) Form-3070G Revisions - Action (S&C 02-26) PDF 161KB #26 04/29/02
Onsite Versus Paper Revisits - Applicability to May 3, 2001 Revisit Policy (S&C 02-25) #25 04/29/02
Clarification of Memo S&C-02-19 - Recalled Sprinkler Heads - Action (S&C 02-24) #24 04/29/02
Voluntary Termination of a Skilled Nursing Facility (SNF) or Nursing Facility (NF) (S&C 02-23) #23 04/29/02
Initiating On-Site Visits To Facilities Enrolled In the CLIA Program That Have a Certificate of Waiver Certificates - Revised (S&C 02-22) - PDF 232KB #22 04/01/02
Resolving Disagreements Resulting from Federal Oversight and Support Surveys (S&C 02-21) - PDF 217KB #21 03/25/02
Review of Time Frames for Reporting Abuse; Reporting Abuse to Law Enforcement; Displaying Complaint Telephone Numbers; and Clarification on Defining and Citing Abuse (S&C 02-20) #20 03/28/02
Recalled Sprinkler Heads (S&C 02-19) #19 03/08/02
Intermediate Care Facilities for Persons with Mental Retardation (ICFs/MR) Form 3070G Revisions (S&C 02-18) - PDF 117KB #18 02/06/02
Completion of Minimum Data Set (MDS) in Critical Access Hospitals (CAHs) (S&C 02-17) #17 02/01/02
Clarification of CMS Policies Regarding Ambulatory Surgical Centers-Effective Immediately (S&C 02-16) #16 02/01/02
Clarification of Hospital Admission and Presurgical History and Physical Examination (H&P) Requirements (S&C 02-15) #15 01/28/02
Certification of False Labor - EMTALA (S&C 02-14) #14 01/16/02
Services Provided by Home Health Agencies (HHAs) (S&C 02-13) - PDF 82KB #13 01/07/02
Implementation of Outcome-Based Quality Improvement (OBQI) Reports (S&C 02-12) - PDF 200KB #12 01/09/02
Nursing Home Off-Hour Data Indicator in OSCAR (S&C 02-11) - PDF 110KB #11 12/20/01
Comparative Surveys for Fiscal Year 2002 (S&C 02-10) - PDF 99KB #10 12/20/01
Discontinuance of Contract with Integriguard (Division of California Medical Review Inc.) to visit Community Mental Health Centers (CMHCs) after January 15, 2002 (S&C 02-09) - PDF 109KB #9 12/20/01
Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) Federal Monitoring and Oversight Survey Data (S&C 02-08) - PDF 484KB #8 12/21/01
Hospital Capacity-EMTALA (S&C 02-06) #6 11/29/01
Alert and Action: End Stage Renal Disease (ESRD) Dialyzer Recall by Baxter (S&C 02-05) - PDF 189KB #5 11/14/01
Question and Answer Relating to Bioterrorism and the Emergency Medical Treatment and Labor Act (EMTALA) (S&C 02-04) #4 11/08/01
Training Request for CMS's Nutrition/Hydration Awareness Campaign (S&C 02-03) #3 10/30/01
Outcome and Assessment Information Set (OASIS) Requirements in New Home Health Agencies (HHAs) Seeking Medicare Certification Including HHAs Seeking Deemed Status Through an Approved Accrediting Organization (AO) (S&C 02-02) - PDF 771KB #2 10/16/01
Abuse and Neglect Detection and Prevention Training (S&C 02-01) #1 10/10/01
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Last Modified on Monday, October 04, 2004