Quality Assessment and Assurance: Federal Requirements for Implementation on October 1, 2006

June 2006

Information Bulletin 06-04

Quality Assessment and Assurance: Federal Requirements - Revision of Appendix PP, State Operations Manual (SOM), Surveyor Guidance for Quality Assessment and Assurance


Implementation Date: October 1, 2006


The purpose of this information bulletin is to inform providers that Minnesota Department of Health surveyors and investigators effective October 1, 2006 will implement Survey Guidelines and Regulatory Changes related to (F520) Quality Assessment and Assurance found in CMS Transmittal 19 and CMS Survey and Certification Letter 06-11.

Background Federal Changes:

The Centers for Medicare and Medicaid Services (CMS) issued revised Long Term Care Surveyor Guidelines for Quality Assessment and Assurance in CMS Survey and Certification Letter 06-11 in March 2006. Included in CMS Survey and Certification Letter 06-11 are the following files:

  • Guidance Training Instructor Guide – (pdf file);
  • PowerPoint presentation file – (PowerPoint file); and
  • Advance copy of Tag F520 Guidance – (Word file).

These guidelines can be accessed via CMS Transmittal 19 (R19SOMA) and CMS Survey Certification Letter 06-11 at the CMS website:

CMS Survey & Certification

  • Click Policy and Memos to States and Regions on the left Navigation bar
  • You can scroll down the list by Memo Number and Date
  • Click on the link for the specific policy or letter.
CMS Manuals
  • Under "Related Links Inside CMS", select CMS Transmittals.
  • Click on 2006 Transmittals and select R19SOMA
  • .

The content of the transmittal has been updated by CMS on the web version of the State Operations Manual (SOM) and may be accessed in Appendix PP of the SOM (PDF).

These changes are part of an ongoing CMS project to issue guidance relating to the expanded clinical interpretive guidelines, surveyor investigative protocol and specific severity guidance for determining the correct level of severity of outcome related to quality assessment and assurance. These revised guidelines include examples of deficient practices.

Follow-up Communication

Under guidance of a joint provider, consumer and MDH Stakeholder Workgroup, four statewide follow-up telephone conference calls will be conducted related to implementation experiences for:

  • F248, Activities and F249, Activities Director;
  • Psychosocial Outcome Severity Guide and,
  • F520 Quality Assessment and Assurance.

All nursing home providers and interested parties are invited to participate. All phone conferences are scheduled from 11:00 a.m. to 12:00 noon. Each nursing home is requested to use one line. There is no charge to participate.

  • Call in number is 1-800-619-9985. Meeting ID# for participants is 7082253.
     November 20, 2006     January 22, 2007

    March 19, 2007 - Rescheduled for: March 26, 2007

    July 23, 2007

If you have any questions regarding this Information Bulletin, please contact in writing:

Minnesota Department of Health
Health Regulation Division
Licensing and Certification Program
85 East Seventh Place, Suite 300
PO Box 64900
St. Paul, MN 55164-0900
Telephone: (651) 201-4101


Update Monday, February 09, 2015 at 02:54PM