Just as the Phase 2 Requirements of Participation for care centers took effect, CMS issued its final version of the State Operations Manual (SOM), Appendix PP – Guidance to Surveyors for Long Term Care Facilities. There are a number of changes to the “Advance Copy” of Appendix PP that it had released on June 30, 2017. Most of the changes are technical (correcting typos, moving language from one spot to another without changing the wording, etc.), but there substantive changes, too. The revisions relate to Medicare coverage notices, hospice services, pressure ulcers, crushing medications, facility assessment, emergency power, resident bedrooms (physical plant) and smoking policies.
