PRN Psychotropic Medications for Behaviors: Learn How to Document to Survive Survey

PRN Medication Use is one of the few sections of the revised F605 (Right to Be Free From Chemical Restraints/Unnecessary Psychotropic Medications) in Appendix PP of the State Operations Manual that does not have changes that went into effect on April 28, 2025. However, the updated examples of F605 noncompliance …

Enhancing Resident Well-Being: A Nursing Leadership Approach to Sensory Impairments

Sensory impairments, such as loss of vision, hearing, taste, smell, or touch, are common among older adults, and significantly affect their quality of life. These impairments often go unnoticed or may be mistaken for cognitive decline, leading to missed opportunities for interventions, or worse, a decline in function. Residents with …

TIP: CMS Revised F641, Accuracy of Assessment, Among Other Tags

The Centers for Medicare & Medicaid Services (CMS) recently confirmed the revisions to the State Operations Manual (SOM), Appendix PP, which went into effect April 28, 2025. The revisions are redlined here. While many revisions were made, nurse assessment coordinators should especially note changes in F641, Accuracy of Assessment. The …

iQIES Nursing Homes – Surveys Workbook for Surveyors

This workbook simulates the survey functions in iQIES and may provide a bare-bones (i.e., basic) walkthrough of how surveyors will approach survey using iQIES. To access, go to https://qtso.cms.gov/software/iqies/reference-manuals Then go to the section titled iQIES Training Environment Access Instructions for State Agencies and CMS Locations Then you can download the …

Appendix PP Updates: Admission, Transfer, and Discharge

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, director of education and certification strategy for AAPACN, discuss the new Appendix PP updates related to admission, transfer, and discharge going into effect April 28, 2025. …

TIP: CMS Announces Training Plan for iQIES for Long-Term Care Survey and Certification

The Centers for Medicare & Medicaid Services (CMS) released a revised memo, QSO-25-07-NH, which detailed a launch plan to transition the long-term care survey process to the Internet Quality Improvement and Evaluation System (iQIES) platform. This transition is currently scheduled to launch July 14, 2025. The CMS iQIES team have …

Appendix PP Revisions: How to Create a Workable Game Plan

A quick review of the draft revised surveyor guidance in Quality, Safety, and Oversight (QSO) memo QSO-25-14-NH that goes into effect on April 28, 2025, may initially concern the director of nursing services (DNS) and other nurse leaders, says Linda Winston, RN, MSN, BS, QCP-MT, DNS-MT, RAC-CT, a nurse consultant …

Caught up in Survey Panic? Make a Plan to Break the Cycle

Hearing a staff member say, “State just walked in the door,” shouldn’t ignite survey panic mode in the director of nursing services (DNS) and other department leaders in the nursing home, says Michelle Synakowski, RN, LNHA, RAC-CT, RAC-CTA, RAC-MT, RAC-MTA, president and CEO of ProSynk Healthcare Compliance Services. Survey does …