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Appendix PP Updates

Posted Sep 12, 20222 min Read

Regulatory & Clinical
The Centers for Medicare and Medicaid Services (CMS) has posted a revised advanced copy of Appendix PP as an attachment to QSO-22-19-NH. The advanced copy was revised to include new regulatory language, which was finalized in the Fiscal Year 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (CMS 1765-F).
The new regulatory language is related to food and nutrition services at 483.60 (a) (2) (i) (E) on page 605, and physical environment at 483.90(a) (1) (iii) on page 794. AHCA/NCAL previously communicated to members about these regulatory changes, which are summarized below.
CMS finalized changes to the requirements for the Director of food and nutrition services as well as physical environment.
  • §483.60(a)(2)(i) Food and nutrition services: CMS is adding allowance for experience in the position as one of the ways to qualify for the position of the director of food and nutrition services. Specifically, an individual who, on the effective date of the final rule (October 1, 2022),  has two or more years of experience in the position of director of food and nutrition services in a nursing facility setting and has completed a course of study in food safety and management by no later than October 1, 2023, along with the other requirements set out at § 483.60(a)(2), is qualified to be the director of food and nutrition services.
  •  §483.90(a)(1)(iii) Physical environment: CMS is adding allowance for existing facilities that are Medicare- or Medicaid-certified before July 5, 2016, and the facility has previously used the Fire Safety Evaluation System for compliance (to determine equivalent fire protection levels), the facility may use scoring values in the Mandatory Values Chart (which is consistent with the 2001 FSES mandatory values) when determining compliance for containment, extinguishment and people movement requirements.
The effective date of these regulation changes is October 1, 2022.