Resources
Federal regulations govern virtually every aspect of operations for a skilled nursing facility (SNF), a hospice, and a home health agency (HHA) and are mandatory. Links to relevant regulations found in the Code of Federal Regulations (CFR) are listed below.
Hospice 42 CFR
Part 418
This part implements section 1861(dd) of the Social Security Act (the Act). Section 1861(dd) of the Act specifies services covered as hospice care and the conditions that a hospice program must meet in order to participate in the Medicare program.
Download our collection of the governing regulations and official guidance that providers must follow in order to achieve and maintain substantial compliance with Medicare’s requirements of participation for health care providers.
Resource Library
Skilled Nursing Facility 42 CFR
Part 483
The provisions of this part contain the requirements that an institution must meet in order to qualify to participate as a Skilled Nursing Facility in the Medicare program, and as a nursing facility in the Medicaid program.
Home Health Agency 42 CFR
Part 484
The provisions of this part serve as the basis for survey activities for the purpose of determining whether an agency meets the requirements for participation in the Medicare program.
State Operations Manual ("SOM")
The "State Operations Manual," commonly referred to as the "SOM" is CMS' guidance to surveyors. It provides "interpretative guidance" to the governing regulations. Below are links to the SOM for SNFs, HHAs, and Hospices. They provide a roadmap to what surveyors will be looking for at your facility.
SOM for SNFs, Appendix PP
Revised August 8, 2024, 873 pages. Provides interpretative guidance to the governing regulations for skilled nursing facilities.
Guidance to Surveyors for Long Term Care Facilities
SOM for HHA, Appendix B
Revised April 4, 2024. CMS guidance to surveyors for home health agencies.
SOM for Hospice, Appendix M
Revised June 7, 2024. CMS guidance to surveyors for hospice facilities.
Other Resources
HHS OIG LEIE
Healthcare providers that participate in any federally funded health program may not employ an individual or entity that has been "excluded" by the HHS Office of the Inspector General (OIG).
CMS QSO Memos
CMS communicates policies to State Agency Directors in part, via QSO Memos. They explain CMS policies and directives (formerly referred to as "S & Q Memos").
Resource Impact
By utilizing the federal regulations and guidance above, Alan has helped healthcare organizations achieve substantial compliance and greater operational efficiency — and remains committed to advancing these results across the field.