QSO-26-03-NH: Revisions to the State Operations Manual (SOM) Chapters 5 and 7 – CMS issued a memo and revisions to the State Operations Manual (SOM) Chapters 5 and 7, effective March 30, 2026.
Memorandum Summary
CMS is releasing the following guidance in Chapter 5 of the SOM:
- Revisions to Immediate Jeopardy Priority Definition examples for Nursing Homes; and
- Clarification of Off-site investigations.
CMS has updated and revised guidance in Chapter 7 of the SOM that includes:
- Survey Team Composition, Survey Procedures, Plans of Correction, Verifying Corrections, Survey Revisit and Offsite Revisit Paper Review, Off-hours Survey, Enforcement, Nurse Staffing Waivers, Disposition of Civil Money Penalties (CMP), Federal Civil Penalties Inflation Reduction Act, Informal Dispute Resolution (IDR), and Independent Informal Dispute Resolution (IIDR);
- Additionally, guidance previously found in Appendix P of the State Operations Manual has been added to Chapter 7; and
- Technical changes that include updates for accurate references.