4 New CMS Survey and Certification Letters

Following are the links to four Survey and Certification Letters posted by CMS from 12/2106 through January 12, 2007.

1. Nursing Home Culture Change Regulatory Compliance Questions and Answers (12/21/06).

http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter07-07.pdf

This Memo includes CMS' responses to State Agency and Regional Office inquiries related to culture change and compliance with health and life safety code requirements, e.g., dining, call system, posting of staffing information; exits; hallway widths. Also included are a summary of questions and answers from a June, 2006 CMS conference with leaders of the Green House Project (Attachment A); and information on the upcoming series of CMS culture change webcasts. The 1st of these was broadcast on November 3, 2006 and is currently archived on the CMS internetstreaming website; the 2nd was scheduled for February 23, but has been postponed. The November 3 broadcast can still be accessed and heard at http://cms.internetstreaming.com

2. Solicitation of State Survey Agency Participation in Quality indicator Survey (QIS) Implementation (12/21/06).

http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter07-09.pdf

This Memo provides information to States not currently participating in the QIS demonstration, and invites them to apply for consideration for future statewide implementation of the QIS survey process.

The memo includes information on the development, design, and objectives of the QIS.
CMS states that, although final evaluation results have not yet been received, preliminary information is positive and that the Agency will move forward to implement the QIS in 8 - 10 additional states.
The selection of these additional states will be based on evaluation of response(s) to this solicitation, including resources to purchase equipment [tablet PCs and portable printers]; the number of NF surveyors in the state; and the number of staff that can be dedicated to learning the QIS while meeting current workload-related statutory obligations.
Attachments detail the criteria for participation and include an application form and instructions for completion.
State Agency responses received by March 1, 2007 will be considered.

3. Medical Gas Storage and Usage Considerations.

http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter07-10.pdf

This Memo is directed toward multiple providers, including hospitals, nursing homes, Programs of All-Inclusive Care for the Elderly (PACE) facilities, and ICFs/MR.

The purpose of the Memo is to respond to questions about storage requirements for small quantities of medical gas and what is considered when determining if a medical gas container is "in use."
CMS clarifies that up to 300 cubic feet of nonflammable medical gas may be accessible as operational supply rather than storage, i.e., located outside of an enclosure at locations open to the corridor, when properly secured.
An individual cylinder placed in a patient's / resident's room for PRN use is considered "in use" and does not need to be stored in an enclosure when properly secured. If not needed for use for an extended period of time, e.g., several days, the container should be removed and properly secured in an approved storage room.

4. New and Revised Clinical Laboratory Improvement Amendments of 1988 (CLIA)

http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter07-12.pdf

This Memo highlights areas of CLIA policies and procedures that were clarified and emphasized during Surveyor Consistency Training conducted in September, 2006. (I recognize most facilities are waivered under CLIA, but this information may be helpful to the limited number of facilities with in-house certified labs.)