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CMS Updates and Expands Surveyor Guidance for Nursing Homes for Phase 2 and 3 RoPs

The Centers for Medicare & Medicaid Services (CMS) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the quality of care and quality of life for residents.

On June 29, 2022, the Quality, Safety & Oversight Group at CMS issued a memorandum entitled “Revised Long-Term Care Surveyor Guidance: Revisions to Surveyor Guidance for Phases 2 & 3, Arbitration Agreement Requirements, Investigating Complaints & Facility Reported Incidents, and the Psychosocial Outcome Severity Guide.”

The CMS Survey Memo clarifies many Phase 2 and Phase 3 Requirements of Participation (RoPs) regulatory requirements and provides information on how surveyors will review those regulations for compliance and assess citations for failure to comply. The CMS Survey Memo also addresses arbitration requirements with guidance on the new requirements which became effective September 16, 2019.

In addition, CMS revised its guidance to State Agencies, on the steps and procedures they use to review and manage complaints and facility reported incidents.


  • Effective October 24, 2022, surveyors will use these guidelines to survey and cite providers;
  • Careful review of your PBJ data and process under these guidelines is needed;
  • Facilities must train staff on these new guidelines and work to document many of these elements for surveyor review; and
  • If you use an arbitration provision in your admission agreement, careful review of those terms and your policies is needed.
To review other key areas and timelines, click here to view an alert notification from Hall & Render.

Surveyors will begin using the guidance in the CMS Survey Memo to identify and cite noncompliance on October 24, 2022.

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