AGING AND DISABILITY SERVICES ADMINISTRATION

2005 NH "Dear Administrator" Letters

September 23, 2005

ADSA: NH #2005-028
Changes in SOM Appendix P and APPENDIX PP

Dear Nursing Facility/Home Administrator:

As you may know, the Centers for Medicare and Medicaid Services (CMS) has been updating the State Operations Manual (SOM) Appendix P and Appendix PP; the survey process and regulatory guidance for nursing homes. On August 18, 2005 CMS issued a memo announcing the final changes to the documents.

Appendix P Changes

• There are no substantive changes from the version previously announced.

Appendix PP Changes

• The following are some of the more substantive changes.
• Tag F172 changed in sentence - “The facility cannot refuse to permit residents to talk with surveyors.”
• Tag F223 added - “Properly trained staff should be able to respond appropriately to resident behavior. CMS does not consider striking a combative resident an appropriate response in any situation. Retaliation by staff is abuse and should be cited as such.”

Nursing home surveyors will begin using the new guidance for survey immediately.

The CMS website is the best source for accessing the most current information available. View the changes at: http://www.cms.hhs.gov/medicaid/survey-cert/letters.asp

Thank you for your continued commitment to the nursing home residents in the state of Washington.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services