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LTC Intrprtive Guide

LTC Interpretive Guidelines for LTC

TermDefinition
The Medicare Conditions of Participation, Conditions for Coverage & Requirements for Skilled Nursing Facilities & Nursing Facilities are... are sets of requirements for acceptable quality in the operation of health care entities.
In addition to each Condition (or Requirement) there is a group of related quality standards. The State Survey Agency ascertains, by a survey conducted by qualified health professionals, whether & how each standard is met.
Interpretive Guidelines serve to interpret & clarify the Conditions or Requirements. The merely define or explain the relevant statute & regulations and not impose any requirements that are not otherwise set forth in statute or regulation.
Each provider type is surveyed in accordance with the appropriate protocols based on the substantive requirements in the statute & regulations to determine whether a citation of... noncompliance is appropriate. Deficiencies are based on a violation of the statute or regulations, which, in turn, are based on observations of the providers' performance or practices.
While an institution may fail to comply with one or more of the subsidiary standards during any given survey, it cannot participate... in Medicare unless it meets each & every Condition or attains substantial compliance with requirements for SNFs & NFs.
Interpretive Guidelines are found: State Operations Manual Appendix PP
The survey protocols & interpretive guidelines serve to clarify &/or explain the intent of the regulations. All surveyors are required to use them in assessing compliance with Federal requirements.
State Operations Manual was developed issuing the protocols for overseeing implementation of... the regulations & to provide guidance to surveyors of long-term care facilities on interpreting the requirements.
Created by: Debra Bernier 1
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