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State Operations Manual - CMS

State Operations Manual Appendix AA - Psychiatric Hospitals Interpretive guidelines and Survey Procedures (Rev. 149, 10-09-15) Transmittals for Appendix AA Part I Investigative Procedures Survey Protocol - Psychiatric Hospitals I - Principal Focus of Surveys II - Task 1 - Representative Sample of Patients - Selection Methodology A - Purpose of the Sample B - Sample Size C - Sample Selection D - Program Audit Approach III - Task 2 - Record Review of Individuals in the Sample A - Introduction B - Other Pertinent Information IV - Task 3 - Other Record Reviews A - Death Records B - discharge Records C - Complaint Investigations V - Task 4 - Direct Patient Observations A - Purpose B - Documentation VI - Task 5 - Interviews A - Patient Interviews B - Purpose of Structured Interviews Related to Patient Staffing C - Documentation D - Interviews with Major Department Directors

with the Discharge Planning Standard (see specific instructions under that Standard’s interpretive guidelines and survey procedures). Review only the discharge summaries and discharge plans. The survey team reviews no less than five (5), but no more than ten (10), discharge records. The records will represent several or all program areas. Do not

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