The Centers for Medicare & Medicaid Services (CMS) released a memo on January 16 announcing further updates to the long-term care surveyor guidance, Appendix PP of the State Operations Manual. Appendix PP was most recently updated in November 2024 with an anticipated implementation date of February 24, 2025. With the new updates, the effective date of the new guidance has been extended to March 24, 2025.

Other updates include the addition of guidance on nurse staffing and payroll-based journal. CMS instructs surveyors how to use payroll-based journal data in reviewing for sufficient nurse staffing and Director of Nursing requirements. The new guidance instructs surveyors in interviewing staff and residents/representatives to determine sufficient staffing. Review the updated guidance here.