Ref: QSO-21-08-NLTC TO: FROM

Page 1 of 12 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop C2-21-16 Baltimore, Maryland 21244-1850 Center for Clinical Standards and Quality/Quality, Safety & Oversight Group Ref: QSO-21-08-NLTC DATE: December 30, 2020 TO: State Survey Agency Directors FROM: Director Quality, Safety & Oversight Group SUBJECT: Revised COVID-19 Focused Infection Control Survey Tool for Acute and Continuing Care Memorandum Summary CMS is committed to taking critical steps to ensure America s health care facilities areprepared to respond to the COVID-19 Public Health Emergency. Revised COVID-19 Focused Infection Control Survey Tool: CMS is makingrevisions to the non-long term care (NLTC) focused infection control survey tool foracute and continuing care providers to reflect COVID-19 guidance updates, provideclarifications to existing information, and update the appropriate CMS regulatory tagconsiderations if a citation is On January 31, 2020, the Secretary of Health and Human Services determined that a Public Health Emergency

in the appropriate provider/supplier appendix of the State Operations Manual and related survey instructions. Surveyors may also need to consider investigating concerns related to Emergency Preparedness in accordance with the guidance in Appendix Z of the State Operations Manual (e.g., for emergency staffing). For purposes of this survey tool

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