SOM Appendix A - CMS

State Operations Manual Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals Table of Contents (Rev. 176, 12-29-17) Transmittals for Appendix A Survey Protocol Introduction Task 1 - Off-Site Survey Preparation Task 2 - Entrance Activities Task 3 - Information Gathering/Investigation Task 4 - Preliminary Decision Making and Analysis of Findings Task 5 - Exit Conference Task 6 Post-Survey Activities Psychiatric hospital Survey Module Psychiatric Unit Survey Module Rehabilitation hospital Survey Module Inpatient Rehabilitation Unit Survey Module hospital Swing-Bed Survey Module Regulations and Interpretive Guidelines Basis and Scope Provision of Emergency Services by Nonparticipating Hospitals Condition of Participation.

The modules for PPS-exempt units (psychiatric and rehabilitation), psychiatric hospitals, rehabilitation hospitals and swing-bed hospitals are attached to this document. The survey team is expected to use all the modules that apply to the hospital being surveyed. For example, if the hospital has swing-beds, a PPS excluded rehabilitation unit, and a

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