CMS Webinar on W249 – Active Treatment Implementation

W249 CMS Surveyor Training Webinar Available for Viewing: Please click on the link below to access the webinar presented by Melissa Rice of CMS Baltimore office and David Piotrowski, Federal Contract Surveyor of ICFs/IID. The topic of the webinar is W249 – Active Treatment is implemented once the IPP is developed. The webinar was developed as a result of a Quality Assurance project conducted by CMS in which they reviewed select survey reports from various regions and reviewed the data on how often this regulation is cited. The goal of the webinar is to increase consistency across the country among survey agencies. The training provides an overview of W249, presents various scenarios for possible citation and covers the principles of documentation that should be followed when surveyors write up a finding. Run time is 99 minutes. This link will take you to the site and open up the presentation through Adobe Presenter. You may be asked to download or update your Adobe program.

CMS Publishes New Survey Guidelines for ICF/IID

Click here to download 2015 Update to SOM Appendix J ICF IG

 Click here to download new Exhibit 355 to SOM Appendix J

The new Interpretive Guidelines for ICF/IID regulations have been implemented and are effective as of April 27, 2015. click on the link above to download the new Appendix J to the State Operations Manual. Some changes have been made to this posting from the Advance Copy previously released in January 2015. No guidance revisions were made to W115, W118, W139, W161, W162, W175-W178, W188, W226, W265, W357, W364, W377-W382, W387-W391, W409-W413, W418, W432-W434, W452, W453, or W471. The probes and procedures previously contained under the guidance have been placed into a State Operations Manual (SOM) Exhibit. New exhibit 355 is being added to SOM Appendix J containing surveyor probes and procedures previously in Appendix J, Part II – Interpretive Guidelines for ICF/IID. The probes and procedures provide surveyors with additional clarification, beyond the guidance in Appendix J, in interpreting the regulation text.

H&W is developing a document that will illustrate the changes from the previous IGs and give guidance to providers on the new expectations, including additional policies and procedures that are outlined in the updated IGs. Look for emails and announcements when these offerings become available in the near future. Please assure that we have your updated email information.



In April 2015, CMS published the ICF/IID Appendix J – Interpretive Guidelines (IGs) to clarify the intent of the Conditions of Participation (CoPs) for ICF/IID and incorporate current standards of practice. This change was the first comprehensive update to the IG in nineteen years. Less than 10% of the interpretation for the regulatory W-tags remained the same. It is critical to update your resource materials to stay current for CMS surveys.

As part of the change, the Compliance Principles, probes and procedures were removed from the IGs and placed into a separate Exhibit (Exhibit 355) behind the IGs. To fully interpret the regulations it is now necessary to refer to two separate sections of the regulations. CMS published a further update on August 14, 2015.

H&W incorporated the Exhibit 355 section with the IGs (including the most recent update) so that the guidance, probes and procedures for each regulation, are now found on a single page. Available for purchase and download as a PDF document.

To buy your copy of this highly useful reference guide for only $89, please visit the H&W Online Store. Discounts are available for 5 and 10 copy bundles.