Clinical Web Window

Clinical Web Window
Health Regulation Division

The purpose of this "window" is to create an easily accessible place where clinical issues can be presented on a regular basis. We hope that this will contribute to high quality care in the Long Term Care (LTC) continuum, will provide a forum for discussion of the regulatory approach to clinical issues and will, when possible, alert practitioners to clinical issues that may come under increased scrutiny during surveys. We will also place surveyor training resources on this site. While it is our goal to anticipate and alert providers to new clinical issues that may affect survey trends, standards for compliance continue to be based on the existing state and federal regulations. Contributors to this website will include Health Regulation staff, and when available or needed, practitioners with a special interest or expertise. We invite comments, suggestions and requests that will enhance the dialogue among all stakeholders involved in LTC.

For more information regarding the clinical updates please contact:

Minnesota Department of Health
Health Regulation Division
85 East Seventh Place, Suite 300
St. Paul, Minnesota 55101
Telephone: 651-201-4101


Online Resources for Long Term Care Practitioners (Minnesota Department of Health Websites)

Accidents and Supervision F323

Handouts/Training materials for the September 17, 2007 Joint Guidance Training for Accidents and Supervision F323


Quality of Life Initiative for Activities F248/249 - An Interdisciplinary Approach
Toolkit - January 16, 2007

Activities of Daily Living

Care Delivery Process

Strategic Approaches to Improving the Care Delivery Process
May 2010 Joint Statewide Training - Dr. Steven Levenson, MD, CMD

Comprehensive Assessment

Summarizing Comprehensive Resident Assessment Information (PDF)
September 2007

Coordination Hospice & Nursing Home Services

Coordination of Hospice and Nursing Home Services (PDF)
April 30, 2009

Dementia Care in Nursing Homes

Care of Persons with Dementia and Unnecessary Medication Use F309 Quality of Care and F329 Unnecessary Drugs

Educational Resources and Optional Tools/Forms:

  1. Advancing Excellence: Nursing Homes
    Advancing Excellence: CMS Launches Partnership to Improve Dementia Care in Nursing Homes
    Partnership to Improve Dementia Care in Nursing Homes Suggestions for Provider Checklist (PDF)
  2. Pharmacy Review Forms:
    Admit to Facility (PDF)
    Facility Initiated (PDF)
    Medication History (PDF)
  3. Physician Round Tool and Instructions (Word file)

Letter from the Minnesota Partnership to Improve Dementia Care to Medical Directors, Physicians, Physician Extenders (PDF)

Surveyor Training Presentation:

Revised Nursing Home Surveyor Guidance for Improved Resident Care: Care of Persons with Dementia and Unnecessary Medication (PDF)

CMS S&C Memos:

Request to Convey Information: Partnership to Improve Dementia Care in Nursing Homes (PDF)

“Hand in Hand: A Training Series for Nursing Homes,” on Person-Centered Care of Persons with Dementia and Prevention of Abuse (PDF)

Release of Mandatory Surveyor Training Program on Care of Persons with Dementia and Unnecessary Antipsychotic Medication Use – Release of Third Video (PDF)

Advanced Copy: Dementia Care in Nursing Homes: Clarification to Appendix P State Operations Manual (SOM) and Appendix PP in the SOM for F309 – Quality of Care and F329 – Unnecessary Drugs (PDF)

Checklist Review of Care and Services for a Resident with Dementia (PDF)


Minnesota Department of Health Diabetes Program

Diabetes Management in the Nursing Home Setting: Clinical Tips - July 21, 2004


Nursing Home Surveyor Training Resources - December 2005
A training resource for surveyors regarding reviewing dignity during the nursing home survey process.

End of Life (F309), Advance Directives (F155), Feeding Tubes (F322/F321)

CMS Nursing Home Guidance Revision:

End of Life (F309)
Center for Clinical Standards and Quality/Survey & Certification Group: F tag 309—Quality of Care- Advance Copy (PDF)

Advance Directives (F155)
Center for Clinical Standards and Quality/Survey & Certification Group - F tag 155-- Advance Directives- Revised Advance Copy (PDF)

Feeding Tubes (F322/F321)
Center for Clinical Standards and Quality/Survey & Certification Group - F tag 322—Naso-Gastric Tubes - Revised Advance Copy (PDF)

CMS QIS Survey Forms on CMS website

See: Critical Elements for Hospice and/or Palliative Care
See: Critical Elements for Tube Feeding Status

Web-based Resources (PDF)

Federal Ambulatory Surgical Centers (ASC)/State Licensed Outpatient Surgical Centers

Updates from CMS

Please Note: It is recommended that providers check the CMS website weekly for new program letters, for information regarding the State Operations Manual and updates.
See CMS Survey and Certification - General Information

Federal Regulations

CMS Manual System - Revised Appendix L, Interpretive Guidelines for Ambulatory Surgical Centers (PDF)

Federal Abuse, Mistreatment, Neglect, Misappropriation of Property

Compliance with Federal Nursing Home Regulations:
F223,F224,F225,F226 and F323 in part.

Tool: Federal Long Term Care Reportability for Abuse Under F225 Resident to Resident Altercations (PDF)

Tool: Federal Long Term Care Reportability Under F225 Injuries of Unknown Source (PDF)

Federal Infection Control Surveyor

Federal Infection Control Surveyor Worksheet (PDF)

Minnesota State Regulations

Minnesota Chapter 4675 - Outpatient Surgical Centers

Training Documents

Appendix L, Ambulatory Surgical Centers Comprehensive Revision (PPT)

Infection Control Program (PPT)

Flash Sterilization

CMS - Flash Sterilization Clarification - FY 2010 Ambulatory Surgical Center (ASC) Surveys (PDF)

Food and Drug Administration

Food and Drug Administration for Health Professionals
This is a site that may be useful as a bookmark.
Publication provides information to healthcare professionals to enhance communication of new drug safety information, raise awareness of reported adverse events, and stimulate additional adverse event reporting.

Health Care Reform/Affordable Health Care Act

Health Care Reform/Affordable Health Care Act - Leadership Summit April 26, 2010 (PDF)

Infection Control

CMS - Nursing Homes - Issuance of Revisions to Interpretive Guidance at F Tag 441, as Part of Appendix PP, State Operations Manual (SOM), and Training Materials (PDF)

Revisions to Appendix PP - Interpretive Guidelines for Long-Term Care Facilities, Tag F441 Infection Control (Transmittal 55 - December 2, 2009 (PDF)

F441 Infection Control Training Handouts - November 12 & 13, 2009

Nutrition and Food Sanitation

A statewide video conference training session conducted October 3, 2008. The following handouts pertain to this training.

Pain Management/F309

Pressure Ulcers

A Physician's, Practitioner's & Clinician's Reference Guide for Pressure Ulcer Prevention & Treatment - March 2005 (PDF)  
Printable Brochure. May be downloaded and copied back to back.

Pressure Ulcer Questions and Answers - September 28, 2005
This listing of frequently asked questions and answers was compiled by Stratis Health in response to Minnesota providers' questions related to pressure ulcers.

Pressure Ulcer/Non-pressure Ulcer Follow-up Training - January 2006 (PowerPoint presentation)

CMS Regional Office Long-Term Care Provider Associations Meeting (PowerPoint) - Pressure Ulcer PowerPoint Training - August 2007

Quality of Life

Range of Motion

F317/F318 Range of Motion (PDF)  - June 2007

Root Cause Analysis

Presentations: Updated July 2010


Unnecessary Medications F329

Paginated materials extracted from CMS Transmittal 22- Pharmacy Training- January 2007

Dr. Steve Levenson PowerPoint: Medications F329 (PDF) - July 2007

Dr. Steve Levenson F329 materials from September 6, 2007 phone conference:

Urinary Incontinence

Urinary Incontinence and Catheters - September 12, 2005
Documents, forms and information provided for a joint MDH and provider video conference training session on urinary incontinence and catheters.


Updated Thursday, July 13, 2017 at 01:41PM