Memorandum Summary – Posting Date: 03/10/25

Revised Surveyor Guidance: CMS is releasing the following revised guidance for nursing home surveyors:

• Admission, Transfer & Discharge, Chemical Restraints/Unnecessary Psychotropic
Medication, Resident Assessment, Nursing Services, Payroll Based Journal, Quality of Life and Quality of Care, Administration, Quality Assurance Performance Improvement
(QAPI), Infection Prevention and Control, and other areas.
• Clarifications and technical corrections have also been made throughout Appendix PP.

Associated Training and Resources:
• Training on this guidance will be available upon release of this memorandum for surveyors and providers.
• Advance copy of the Critical Element Pathways are attached to this memo.
• Advanced copy of Appendix PP is attached to this memo.
• Revised Survey Resources will be posted on March 24, 2025.

Effective Date: Surveyors will begin using this guidance to determine compliance with requirements on surveys beginning April 28, 2025.

Effective Date: Revised to move implementation from March 24, 2025 to April 28, 2025. Surveyors will begin using this guidance to determine compliance with requirements on surveys beginning April 28, 2025. This allows ample time for surveyors and nursing home providers to be trained on this new information.

Added revised guidance and training for Nursing Services and Payroll Based Journal to the updates for Appendix PP and the Long-Term Care Survey Process and revised the effective date of implementation for all new guidance to April 28, 2025.

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