Federal Nursing Home Regulation Resources

Federal CMS (Centers for Medicare & Medicaid Services) Nursing Home Regulation Resources

Minnesota Department of Health Resources

Online Resources for Long Term Care Providers
Links to relevant sites for surveyors and providers.

Immediate Jeopardy

CMS, Center for Clinical Standards and Quality/Quality, Safety & Oversight Group memo QSO-19-09: Revisions to Appendix Q, Guidance on Immediate Jeopardy

Surveyor Resources When an Immediate Jeopardy is Called in Accordance with QSO 19-09

Surveyor Guide to Calling an Immediate Jeopardy

Submitting a Removal Plan for Immediate Jeopardy

2017 Long-Term Care (LTC) Training Resources

Quality, Safety & Education Portal (QSEP) - LTC Survey Process SME Videos
This course consists of a series of videos created by CMS outlining essential topics related to changes in the LTC regulations scheduled to be implemented for Phase 2. CMS videos on guidance provide regions and states a resource that can be used for training and education with surveyors, providers, and other stakeholder groups.

Topics include:

  • Admission, Transfer, Discharge
  • Appendix PP-Overview of Revised Interpretive Guidance
  • Behavioral Health
  • Facility Assessment
  • Freedom from Abuse, Neglect and Exploitation
  • Infection Control
  • Person-Centered Care
  • Pharmacy Services
  • Quality Assurance and Process Implementation Plan- The Basics
  • Quality of Life and Quality of Care
  • Nursing Services

PLEASE NOTE: More training videos to come, which will include the following areas: Comprehensive Person-Centered Care Planning, Physician Services, Lab/X-ray/Diagnostic, Dental, Food and Nutrition, Specialized Rehab, Administration, Physical Environment, Training, and additional videos on Resident Rights, Quality of Life, Quality of Care and Nursing Services.

Instructions for finding survey process videos on CMS website:

  1. Go to Quality, Safety & Education Portal (QSEP) website.
  2. Select I AM A PROVIDER.
  3. Select Course Catalog on top of task bar.
  4. In the search box, type “LTC Survey Process SME Videos.”
  5. Select course under Course Information.
  6. Select Launch the Course, select a SME video, wait for course to download. When complete, return to list of videos for additional training.

Quality, Safety & Education Portal (QSEP) - Overview of the New Long Term Care (LTC) Survey Process for LTC Providers
Provider training available on Quality, Safety & Education Portal (QSEP). This presentation provides an introduction to new regulatory reform, key changes to the survey process, the rationale behind the changes to the survey process, and the basic steps in the survey process that are important to the LTC Provider. The expected run time for this training is an hour.

MDH Provider, Surveyor, Investigator, Ombudsman Training

The 2017 Federal Nursing Home Regulations: A Person Centered Approach (PDF)

Hand in Hand Training Series

The updated Hand in Hand: A Training Series for Nursing Homes is now available on the CMS’s Integrated Surveyor Training Website (ISTW). Hand in Hand is available as a self-paced training as well as an instructor-led course and may be accessed using the links below. The self-paced training may take approximately 24 hours to complete.

Self-Paced Online Training: Quality, Safety & Education Portal (QSEP) - Hand in Hand: A Training Series for Nursing Homes Online

Downloadable Materials for Instructor-Led Training: Quality, Safety & Education Portal (QSEP) - Hand in Hand: A Training Series for Nursing Homes Download

Training Description

This training focuses on caring for residents with dementia and on preventing abuse. CMS, supported by a team of training developers and subject matter experts, created this training to address the need for nurse aides’ in-service training on these important topics.


The Hand in Hand: A Training Series for Nursing Homes was previously developed as an instructor-led training conducted by nursing home staff for nurse aides. The Hand in Hand training will now be available as a self-paced, online training and available to download for use as an instructor-led course.

Target Audience

Federal law requires that nurse aides complete in-service training on dementia management and resident abuse prevention. Additionally, facilities must provide dementia management and resident abuse prevention training to all facility staff, (direct and indirect care and auxiliary functions) contractors, and volunteers.

CMS Resources

Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities
This site provides additional vital information about the background and overview of the final rule, frequently asked questions and other related resources. Includes access to documents, forms and information regarding the new long-term care survey process. This site provides links to the current Appendix PP 03-08-2017 (Effective through November 27, 2017), Advance Appendix PP including Phase 2 (Effective November 28, 2017), List of revised F-tags, F-tags Crosswalk and other useful information.

It will be the responsibility of providers to check periodically for new information listed on the CMS Reform for Long-Term Care Facilities website. This website is subject to change by CMS.

CMS Survey and Certification (S&C) Memos

CMS Policy & Memos to States and Regions
Below are S&C memos related to emergency preparedness (S&C 17-29) and LTC regulations (S&C 17-19 and 17-36). CMS issues S&C memos weekly. It will be the responsibility of providers to check weekly for new information listed at the CMS S&C memo website.

CMS Transmittals

November 22, 2017 CMS Transmittal: Revisions to State Operation Manual (SOM), Appendix PP Guidance to Surveyors for Long Term Care Facilities (PDF)


Federal Nursing Home Regulation Clarifications

  • Crushing of Medications
  • Director of Food and Nutrition Services clarification posted 4/2018
    Question: Does the Minnesota Certified Food Manager course administered through the Minnesota Department of Health Environmental Health Division meet the federal nursing home regulatory requirement at §483.60(a)(2)(ii)?

Federal Data including Deficiency Citations

CMS Memo: Quality and Certification Oversight Reports (QCOR) Website Launch (PDF)

Quality and Certification Oversight Reports (QCOR) Website includes federal data, including deficiency data link for on-site inspections of providers and suppliers.

Emergency Preparedness

Emergency Preparedness Resources and Surveyor Tool

Dementia Care in Nursing Homes

Educational Resources and Optional Tools/Forms:

  1. National Partnership – Dementia Care Resources
  2. Pharmacy Review Forms:
    Admit to Facility (PDF)
    Facility Initiated (PDF)
    Medication History (PDF)
  3. Physician Round Tool and Instructions

Letter from the Minnesota Partnership to Improve Dementia Care to Medical Directors, Physicians, Physician Extenders (PDF)

Quality, Safety & Education Portal (QSEP) - “Hand in Hand: A Training Series for Nursing Homes,” on Person-Centered Care of Persons with Dementia and Prevention of Abuse

Food and Drug Administration

Food and Drug Administration for Health Professionals
Publication provides information to healthcare professionals to enhance communication of new drug safety information, raise awareness of reported adverse events, and stimulate additional adverse event reporting.

Root Cause Analysis

Presentations: Updated July 2010


Contact Information

Minnesota Department of Health
Health Regulation Division
85 East Seventh Place, Suite 300
St. Paul, Minnesota 55101


Updated Wednesday, July 28, 2021 at 10:33AM