Psychosocial Outcome Severity Guide: Federal Requirements for Implementation on October 1, 2006

June 2006

Information Bulletin 06-05

Psychosocial Outcome Severity Guide: Federal Requirements - Revision of Appendix P, State Operations Manual (SOM), Survey Protocol for Long Term Care

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 Protocol for Long Term Care Guidelines related to the Psychosocial Outcome Severity Guide found in CMS Transmittal 20 and CMS Survey and Certification Letter 06-10 and 06-20. No changes have been made to the Guide that was sent out as an advance copy in memorandum S&C-06-10.

Background Federal Changes:

The Centers for Medicare and Medicaid Services (CMS) issued the Psychosocial Outcome Severity Guide in CMS Survey and Certification Letter 06-10 in March 2006. Included in CMS Survey and Certification Letter 06-10 are the following files:

  • Advance copy of Psychosocial Outcome Severity Guide – (Word file);
  • Training Instructor Guide – (pdf file); and
  • Powerpoint presentation file – (PowerPoint file).

These guidelines can be accessed via CMS Transmittal 20 (R20SOMA) and CMS Survey Certification Letter 06-10 and 06-20 at the websites below:

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, and then 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 R20SOMA.
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 P of the SOM (PDF)

CMS Sponsored Video-on-Demand Webcasts.

CMS has developed a free webcast program entitled, “Introducing the New Psychosocial Outcome Severity Guide”. This webcast has been developed to introduce surveyors to the new Psychosocial Outcome Severity Guide and how to use the Guide in determining the severity of any deficiency that has a psychosocial outcome.

It may be accessed at: [expired link]

These changes are part of an ongoing CMS project to issue guidance relating to the expanded clinical interpretive guidelines, surveyor investigative protocols and specific severity guidance for determining the correct level of severity of outcome to residents from deficiencies related to psychosocial outcomes. 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 02:55PM