In June 2022, the Centers for Medicare & Medicaid Services (CMS) published revised guidance for nursing home surveyors available in the links below. Appendix PP provides interpretive guidelines for long-term care facilities. Critical Element Pathways* are used for investigating potential care areas of concern. Surveyors will begin using this guidance to identify noncompliance on October 24, 2022.

Appendix PP – Guidance for Surveyors
Psychosocial Outcome Severity Guide
Abuse*
Accidents*
Activities*
Activities of Daily Living*
Arbitration*
Behavioral-Emotional*
Beneficiary Notice*
Bladder and Bowel Incontinence*
Comm-Sensory*
Death*
Dementia Care*
Dental*
Dialysis*
Dining*
Discharge*
Environment*
Extended Survey*
General*
Hospice and End of Life*
Hospitalization*
Hydration*
Infection Prevention Control and Immunization*
Kitchen*
Medication Administration*
Medication Storage*
Neglect*
Nutrition*
Pain Management*
PASARR*
Personal Funds*
Physical Restraints*
Positioning, Mobility, ROM*
Pressure Ulcer*
QAPI and QAA*
Rehab and Restorative*
Resident Assessment*
Resident Council*
Respiratory Care*
Sufficient and Competent Staff*
Tube Feeding*
Unnecessary Medications*
Urinary Catheter or UTI*

Note: LTCCC’s Guide to Nursing Home Oversight and Enforcement is a useful resource for anyone interested in understanding what to expect from the government agencies charged with ensuring nursing home resident safety and dignity, from requirements for nursing home inspections to actions on complaints about resident abuse and neglect.