The Centers for Medicare and Medicaid Services (CMS) has made revisions to twenty F-Tags in the State Operations Manual (SOM). The changes reflect the Survey and Certification (S&C) policy memos issued from October 2003 through May 2014.

CMS states it is committed to revising and updating the SOM which includes clarifications to guidelines and changes to acceptable standards of practice as it relates to the regulatory guidance. An advanced copy of the manual can be found here:

Among the F-Tags updated are F208-Admission Policy, F221-Physical Restraints, and F441-Infection Control. The changes to F208 are related to the January 8, 2004, S&C memo that sets out to clarify whether or not nursing homes may use promissory notes or deposit fees as conditions of admission.

CMS changed F221 to reflect the clarifications set out in the S&C memo of June 22, 2007, that clarifies the phrases “removes easily” and “freedom of movement”. The updated guidance set out in F441 comes from four S&C memos dating from 2010 through 2013, and reflect clarifications to the use of insulin pens in the facilities, safe use of single dose/single use medications, point-of-care devices such as finger-prick devices and glucose meters, and laundry and infection control, specifically laundry detergents with/without antimicrobial claims, use of chlorine bleach, water temperatures and maintenance of laundry equipment.

Currently only the advance copy of the revisions available and CMS does indicate that the final version may differ slightly.