The Centers for Medicare and Medicaid Services (CMS) posted the updated
Appendix PP of the State Operations Manual (SOM) as outlined in
QSO-25-14-NH. As noted in the QSO memo, the updates provide significant changes to the surveyor’s guidance in assessing compliance with federal regulations in long term care facilities. These revisions became effective April 28, 2025.
CMS previously released additional updated resources, including updated Critical Element Pathways (CEP) within the
surveyor resources folder.