Attachment F Updated VA F-Tag-Crosswalk 8.2023.pdf

As of: 07/18/2017 Phase 3 Tag Crosswalk -

Effective February 3, 2023

Applicable to VHA CLCs

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.10 Resident Rights F550 X Resident Rights/Exercise of Rights 483.10(a)(1)(2)(b)(1)(2) CMS

483.10 Resident Rights F551 Rights Exercised by Representative 483.10(b)(3)-(7)(i)-(iii) CMS

483.10 Resident Rights F552 Right to be Informed/Make Treatment Decisions 483.10(c)(1)(4)(5) CMS

483.10 Resident Rights F553 Right to Participate in Planning Care 483.10(c)(2)(3) CMS

483.10 Resident Rights F554 Resident Self-Admin Meds-Clinically Appropriate 483.10(c)(7) CMS

483.10 Resident Rights F555 Right to Choose/Be Informed of Attending Physician 483.10(d)(1)-(5) CMS

483.10 Resident Rights F557 Respect, Dignity/Right to have Personal Property 483.10(e)(2) CMS

483.10 Resident Rights F558 X Reasonable Accommodations of Needs/Preferences 483.10(e)(3) CMS

483.10 Resident Rights F559 X Choose/Be Notified of Room/Roommate Change 483.10(e)(4)-(6) CMS

483.10 Resident Rights F561 X Self Determination 483.10(f)(1)-(3)(8) CMS

483.10 Resident Rights F563 Right to Receive/Deny Visitors 483.10(f)(4)(ii)-(v) CMS

483.10 Resident Rights F564 Inform of Visitation Rights/Equal Visitation Priviledges 483.10(f)(4)(vi)(A)-(D) CMS

483.10 Resident Rights F565 X Resident/Family Group and Response 483.10(f)(5)(i)-(iv)(6)(7) CMS

483.10 Resident Rights F566 Right to Perform Facility Services or Refuse 483.10(f)(9)(i)-(iv) CMS

483.10 Resident Rights F572 Notice of Rights and Rules 483.10(g)(1)(16) CMS VHA Rights and Responsibilities

483.10 Resident Rights F573 Right to Access/Purchase Copies of Records 483.10(g)(2)(i)(ii)(3) CMS

483.10 Resident Rights F574 Required Notices and Contact Information 483.10(g)(4)(i)-(vi) CMS

483.10 Resident Rights F575 Required Postings 483.10(g)(5)(i)(ii) CMS VHA Rights and Responsibilities

483.10 Resident Rights F576 Right to Forms of Communication with Privacy 483.10(g)(6)-(9) CMS

483.10 Resident Rights F578 Request/Refuse/Discontinue Treatment;Formulate Adv Directives 483.10(c)(6)(8)(g)(12)(i)-(v) CMS

483.10 Resident Rights F583 Personal Privacy/Confidentiality of Records 483.10(h)(1)-(3)(i)(ii) CMS

483.10 Resident Rights F584 X

Safe/Clean/Comfortable/

Homelike Environment 483.10(i)(1)-(7) CMS

483.10 Resident Rights F585 Grievances 483.10(j)(1)-(4) CMS

483.10 Resident Rights F586 Resident Contact with External Entities 483.10(k) CMS

483.12 Freedom from Abuse, Neglect, and Exploitation F600 X Free from Abuse and Neglect 483.12(a)(1) CMS

483.12 Freedom from Abuse, Neglect, and Exploitation F602 X Free from Misappropriation/Exploitation 483.12 CMS

483.12 Freedom from Abuse, Neglect, and Exploitation F603 X Free from Involuntary Seclusion 483.12(a)(1) VHA

483.10 Resident Rights

483.12 Freedom from Abuse, Neglect, and Exploitation

F604 X Right to be Free from Physical Restraints 483.10(e)(1)

483.12(a)(2)

CMS

483.10 Resident Rights

483.12 Freedom from Abuse, Neglect, and Exploitation

F605 X Right to be Free from Chemical Restraints 483.10(e)(1)

483.12(a)(2)

CMS

483.12 Freedom from Abuse, Neglect, and Exploitation F606 X Not Employ/Engage Staff with Adverse Actions 483.12(a)(3)(4) CMS

VHA Directive provided; local policy also available upon surveyor's request

483.12 Freedom from Abuse, Neglect, and Exploitation F607 X Develop/Implement Abuse/Neglect, etc. Policies 483.12(b)(1)-(4) CMS

VHA Directive provided; local policy also available upon surveyor's request

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.12 Freedom from Abuse, Neglect, and Exploitation F608 X Reporting of Reasonable Suspicion of a Crime 483.12(b)(5)(i)-(iii) CMS

VHA Directive provided; local policy also available upon surveyor's request

483.12 Freedom from Abuse, Neglect, and Exploitation F609 X Reporting of Alleged Violations 483.12(c)(1)(4) CMS

VHA Directive provided; local policy also available upon surveyor's request

483.12 Freedom from Abuse, Neglect, and Exploitation F610 X Investigate/Prevent/Correct Alleged Violation 483.12(c)(2)-(4) CMS

VHA Directive provided; local policy also available upon surveyor's request

483.15 Admission, Transfer, and Discharge F620 Admissions Policy 483.15(a)(1)-(7) CMS

483.20 Resident Assessments F635

Admission Physician Orders for

Immediate Care 483.20(a) CMS

483.20 Resident Assessments F636

Comprehensive Assessments &

Timing 483.20(b)(1)(2)(i)(iii) CMS

483.20 Resident Assessments F637

Comprehensive Assmt After

Significant Change 483.20(b)(2)(ii) CMS

483.20 Resident Assessments F638

Quarterly Assessment At Least

Every 3 Months 483.20(c) CMS

483.20 Resident Assessments F639

Maintain 15 Months of Resident

Assessments 483.20(d) CMS

483.20 Resident Assessments F641 Accuracy of Assessments 483.20(g) CMS

483.20 Resident Assessments F642

Coordination/Certification of

Assessment 483.20(h)-(j) CMS

483.21 Comprehensive

Resident Centered Care Plans Baseline Care Plan 483.21(a)(1)-(3) CMS

483.21 Comprehensive

Resident Centered Care Plans F656

Develop/Implement

Comprehensive Care Plan 483.21(b)(1) CMS

483.21 Comprehensive

Resident Centered Care Plans F657 Care Plan Timing and Revision 483.21(b)(2)(i)-(iii) CMS

483.21 Comprehensive

Resident Centered Care Plans F658

Services Provided Meet

Professional Standards 483.21(b)(3)(i) CMS

483.21 Comprehensive

Resident Centered Care Plans F659 Qualified Persons 483.21(b)(3)(ii)(iii) CMS

483.21 Comprehensive

Resident Centered Care Plans F660 Discharge Planning Process 483.21(c)(1)(i)-(ix) CMS

483.21 Comprehensive

Resident Centered Care Plans F661 Discharge Summary 483.21(c)(2)(i)-(iv) CMS

483.24 Quality of Life F675 X Quality of Life 483.24 CMS

483.24 Quality of Life F676 X

Activities of Daily Living (ADLs)/

Maintain Abilities 483.24(a)(1)(b)(1)-(5)(i)-(iii) CMS

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.24 Quality of Life F677 X

ADL Care Provided for

Dependent Residents 483.24(a)(2) CMS

483.24 Quality of Life F678 X

Cardio‐Pulmonary Resuscitation

(CPR)

483.24(a)(3) CMS

483.24 Quality of Life F679 X

Activities Meet Interest/Needs of Each Resident 483.24(c)(1) CMS

483.24 Quality of Life F680 X

Qualifications of Activity

Professional 483.24(c)(2)(i)(ii)(A)-(D) VHA

483.25 Quality of Care F684 X Quality of Care 483.25 CMS

483.25 Quality of Care F685 X

Treatment/Devices to Maintain

Hearing/Vision 483.25(a)(1)(2) CMS

483.25 Quality of Care F686 X

Treatment/Svcs to Prevent/Heal

Pressure Ulcers 483.25(b)(1)(i)(ii) CMS

483.25 Quality of Care F687 X Foot Care 483.25(b)(2)(i)(ii) CMS

483.25 Quality of Care F688 X

Increase/Prevent Decrease in

ROM/Mobility 483.25(c)(1)-(3) CMS

483.25 Quality of Care F689 X

Free of Accident

Hazards/Supervision/Devices 483.25(d)(1)(2) CMS

483.25 Quality of Care F690 X

Bowel/Bladder Incontinence, Catheter, UTI 483.25(e)(1)-(3) CMS

483.25 Quality of Care F691 X

Colostomy, Urostomy, or

Ileostomy Care 483.25(f) CMS

483.25 Quality of Care F692 X

Nutrition/Hydration Status

Maintenance 483.25(g)(1)-(3) CMS

483.25 Quality of Care F693 X

Tube Feeding

Management/Restore Eating

Skills

483.25(g)(4)(5) CMS

483.25 Quality of Care F694 X Parenteral/IV Fluids 483.25(h) CMS

483.25 Quality of Care F695 X

Respiratory/Tracheostomy care and Suctioning 483.25(i) CMS

483.25 Quality of Care F696 X Prostheses 483.25(j) CMS

483.25 Quality of Care F697 X Pain Management 483.25(k) CMS

483.25 Quality of Care F698 X Dialysis 483.25(l) CMS

483.25 Quality of Care F699 X Trauma Informed Care 483.25(m) CMS

483.25 Quality of Care F700 X Bedrails 483.25(n)(1)-(4) CMS

483.30 Physician Services F711

Physician Visits‐ Review

Care/Notes/Order 483.30(b)(1)-(3) VHA

483.30 Physician Services F712

Physician Visits‐

Frequency/Timeliness/Alternate

NPPs

483.30(c)(1)-(4) CMS

483.30 Physician Services F713

Physician for Emergency Care, Available 24 Hours 483.30(d) CMS

483.30 Physician Services F714

Physician Delegation of Tasks to

NPP

483.30(e)(1)(4)(f) CMS

483.30 Physician Services F715

Physician Delegation to

Dietitian/Therapist 483.30(e)(2)(3) CMS

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.35 Nursing Services F725 Sufficient Nursing Staff 483.35(a)(1)(2) CMS

483.35 Nursing Services F726 Competent Nursing Staff 483.35(a)(3)(4)(c) CMS

483.35 Nursing Services F727 RN 8 Hrs/7 days/Wk, Full Time DON 483.35(b)(1)-(3) VHA RNs are required for at least 8 consecutive hours a day/7 days a week. CLCs are not required to designate an RN to serve as DON full time.

483.40 Behavioral Health

Services F740 Behavioral Health Services 483.40 CMS

483.40 Behavioral Health

Services F741 Sufficient/Competent Staff-Behav Health Needs 483.40(a)(1)(2) CMS

483.40 Behavioral Health

Services F742 X

Treatment/Svc for

Mental/Psychosocial Concerns 483.40(b)(1) CMS

483.40 Behavioral Health

Services F743 X No Pattern of Behavioral Difficulties UnlessUnavoidable 483.40(b)(2) CMS

483.40 Behavioral Health

Services F744 X Treatment /Service for Dementia 483.40(b)(3) CMS

483.40 Behavioral Health

Services F745 X

Provision of Medically Related

Social Services 483.40(d) CMS

483.45 Pharmacy Services F755

Pharmacy

Svcs/Procedures/Pharmacist

/Records

483.45(a)(b)(1)-(3) CMS

483.45 Pharmacy Services F756

Drug Regimen Review, Report

Irregular, Act On 483.45(c)(1)(2)(4)(5) CMS

483.45 Pharmacy Services F757 X

Drug Regimen is Free From

Unnecessary Drugs 483.45(d)(1)-(6) CMS

483.45 Pharmacy Services F758 X

Free from Unnec Psychotropic Meds/PRN Use

483.45(c)(3)(e)(1)-(5) CMS

483.45 Pharmacy Services F759 X

Free of Medication Error Rates of 5% or More 483.45(f)(1) CMS

483.45 Pharmacy Services F760 X

Residents Are Free of Significant

Med Errors 483.45(f)(2) CMS

483.45 Pharmacy Services F761

Label/Store Drugs &

Biologicals 483.45(g)(h)(1)(2) CMS

483.50 Laboratory, Radiology, and Other Diagnostic Services F773

Lab Svs Physician Order/Notify of Results 483.50(a)(2)(i)(ii) CMS

483.50 Laboratory, Radiology, and Other Diagnostic Services F777

Radiology/Diag. Svcs

Ordered/Notify Results 483.50(b)(2)(i)(ii) CMS

483.55 Dental Services F790

Routine/Emergency Dental

Services in SNFs 483.55(a)(1)-(5) CMS

483.55 Dental Services F791

Routine/Emergency Dental

Services in NFs 483.55(b)(1)-(5) CMS

483.60 Food and Nutrition

Services F800

Provided Diet Meets Needs of

Each Resident

483.60 CMS

483.60 Food and Nutrition

Services F801 Qualified Dietary Staff 483.60(a)(1)(2) CMS

483.60 Food and Nutrition

Services F802

Sufficient Dietary Support

Personnel 483.60(a)(3)(b) CMS

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.60 Food and Nutrition

Services F803

Menus Meet Res Needs/Prep in

Advance/Followed 483.60(c)(1)-(7) CMS

483.60 Food and Nutrition

Services F804

Nutritive Value/Appear, Palatable/Prefer Temp 483.60(d)(1)(2) CMS

483.60 Food and Nutrition

Services F805

Food in Form to Meet Individual

Needs 483.60(d)(3) CMS

483.60 Food and Nutrition

Services F806

Resident Allergies, Preferences and Substitutes 483.60(d)(4)(5) CMS

483.60 Food and Nutrition

Services F807

Drinks Avail to Meet Needs/

Preferences/ Hydration 483.60(d)(6) CMS

483.60 Food and Nutrition

Services F808

Therapeutic Diet Prescribed by

Physician 483.60(e)(1)(2) CMS

483.60 Food and Nutrition

Services F809

Frequency of Meals/Snacks at

Bedtime 483.60(f)(1)-(3) CMS

483.60 Food and Nutrition

Services F810

Assistive Devices ‐ Eating

Equipment/Utensils 483.60(g) CMS

483.60 Food and Nutrition

Services F812

Food Procurement, Store/Prepare/Serve ‐ Sanitary 483.60(i)(1)(2) CMS

483.60 Food and Nutrition

Services F813 Personal Food Policy 483.60(i)(3) CMS

483.60 Food and Nutrition

Services F814

Dispose Garbage & Refuse

Properly 483.60(i)(4) CMS

483.65 Specialized

Rehabilitative Services F825

Provide/Obtain Specialized

Rehab Services 483.65(a)(1)(2) CMS

483.70 Administration F836

License/Comply w/Fed/State/Local Law/Prof Std 483.70(a)-(c) CMS

483.70 Administration F838 Facility Assessment 483.70(e)(1)-(3) VHA *VHA has not impleneted

483.70 Administration F839 Staff Qualifications 483.70(f)(1)(2) CMS

483.70 Administration F840 Use of Outside Resources 483.70(g)(1)(2) CMS

483.70 Administration F841 Responsibilities of Medical Director 483.70(h)(1)(2) CMS

483.20 Resident Assessments

483.70 Administration

F842 Resident Records - Identifiable Information

483.20(f)(5)

483.70(i)(1)-(5)

CMS

483.75 Quality Assurance and

Performance Improvement F865 QAPI Program/Plan, Disclosure/Good Faith Attmpt 483.75(a)(b)(f)(h)(i)

483.75 Quality Assurance and

Performance Improvement F866 QAPI/QAA Data Collection and Monitoring 483.75(c)(1)-(4)

483.75 Quality Assurance and

Performance Improvement F867 QAPI/QAA Improvement Activities 483.75(d)(1)(2)(e)(1)-(3)(g)(2)

483.75 Quality Assurance and

Performance Improvement F868 QAA Committee 483.75(g)(1)(i)-(iv)(2)(i)

483.80 Infection Control F880 Infection Prevention & Control 483.80(a)(1)(2)(4)(e)(f) CMS

483.80 Infection Control F881 Antibiotic Stewardship Program 483.80(a)(3) CMS

CMS, VHA Standard Operating Procedure provided

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.80 Infection Control F882

Infection Preventionist

Qualifications/Role 483.80(b)(1)-(4)(c) CMS

483.80 Infection Control F883 X

Influenza and Pneumococcal

Immunizations 483.80(d)(1)(2) CMS

483.90 Physical Environment F906 Emergency Power 483.90(c)(1)(2) CMS

483.90 Physical Environment F907 Space and Equipment 483.90(d)(1) CMS

483.90 Physical Environment F908

Essential Equipment, Safe

Operating Condition 483.90(d)(2) CMS

483.90 Physical Environment F909 Resident Bed 483.90(d)(3) CMS

483.90 Physical Environment F910 Resident Room 483.90(e) CMS

483.90 Physical Environment F911 Bedroom Number of Residents 483.90(e)(1))(i) CMS

483.90 Physical Environment F912

Bedrooms Measure at Least 80

Square Ft/Resident 483.90(e)(1)(ii) CMS

483.90 Physical Environment F913

Bedrooms Have Direct Access to

Exit Corridor 483.90(e)(1)(iii) CMS

483.90 Physical Environment F914

Bedrooms Assure Full Visual

Privacy 483.90(e)(1)(iv)(v) CMS

483.90 Physical Environment F915 Resident Room Window 483.90(a)(7)(e)(1)(vi) CMS

483.90 Physical Environment F916

Resident Room Floor Above

Grade 483.90(e)(1)(vii) CMS

483.10 Resident Rights

483.90 Physical Environment

F917

Resident Room

Bed/Furniture/Closet

483.10(i)(4)

483.90(e)(2)(3)

CMS

483.90 Physical Environment F918 Bedrooms Equipped/Near Lavatory/Toilet 483.90(f) CMS

483.90 Physical Environment F919 Resident Call System 483.90(g)(1)(2) CMS

483.90 Physical Environment F920 Requirements for Dining and Activity Rooms 483.90(h)(1)-(4) CMS

483.90 Physical Environment F921

Safe/Functional/Sanitary/

Comfortable Environment 483.90(i) CMS

483.90 Physical Environment F922 Procedures to Ensure Water Availability 483.90(i)(1) CMS

483.90 Physical Environment F923 Ventilation 483.90(i)(2) CMS

483.90 Physical Environment F924 Corridors Have Firmly Secured Handrails 483.90(i)(3) CMS

483.90 Physical Environment F925

Maintains Effective Pest Control

Program 483.90(i)(4) CMS

483.90 Physical Environment F926 Smoking Policies 483.90(i)(5) VHA

483.95 Training Requirements F940 Training Requirements ‐ General 483.95 CMS

483.95 Training Requirements F941 Communication Training 483.95(a) CMS

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.95 Training Requirements F942 Resident’s Rights Training 483.95(b) CMS

483.95 Training Requirements F943 Abuse, Neglect, and Exploitation Training 483.95(c)(1)-(3) VHA VHA Directive provided; local policy also available upon surveyor's request

483.95 Training Requirements F944 QAPI Training 483.95(d) VHA

483.95 Training Requirements F945 Infection Control Training 483.95(e) CMS

483.95 Training Requirements F946 Compliance and Ethics Training 483.95(f)(1)(2) CMS

483.95 Training Requirements F949 Behavioral Health Training 483.95(i) CMS

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

Not Applicable to VHA CLCs

F540 Definitions 483.5

483.10 Resident Rights F560 Right to Refuse Certain Transfers 483.10(e)(7)(i)-(iii)(8)

A resident can decline relocation from a room in one institution’s distinct part SNF or NF to a room in another institution’s distinct part SNF or NF for purposes of obtaining Medicare or Medicaid eligibility

483.10 Resident Rights F562 Immediate Access to Resident 483.10(f)(4)(i)(A)-(G) state specifc; not federal

483.10 Resident Rights F567 Protection/Management of Personal Funds 483.10(f)(10)(i)(ii) applicable to Medicare/Medicaid as written in SOM

483.10 Resident Rights F568 Accounting and Records of Personal Funds 483.10(f)(10)(iii) not applicable, CLCs are part of a larger complex medical institution and establsihed process of the medical center to oversee funds

483.10 Resident Rights F569 Notice and Conveyance of Personal Funds 483.10(f)(10)(iv)(v) not applicable, CLCs are part of a larger complex medical institution and establsihed process of the medical center to oversee funds

483.10 Resident Rights F570 Surety Bond ‐ Security of Personal Funds 483.10(f)(10)(vi) surety bonds are not applicable in CLCs

483.10 Resident Rights F571 Limitations on Charges to Personal Funds 483.10(f)(11)(i)-(iii) not applicable, CLCs are part of a larger complex medical institution and establsihed process of the medical center to oversee funds

483.10 Resident Rights F577 Right to Survey Results/Advocate Agency Info 483.10(g)(10)(11) Reports protected under U.S.C 38 5705 Quality Assurance

483.10 Resident Rights F579 Posting/Notice of Medicare/Medicaid on Admission 483.10(g)(13) not applicable in CLCs

483.10 Resident Rights F580 Notify of Changes (Injury/Decline/Room, Etc.) 483.10(g)(14)(i)-(iv)

483.10 Resident Rights F582 Medicaid/Medicare Coverage/Liability Notice 483.10(g)(17)(18)(i)-(v) not applicable in CLCs

483.15 Admission, Transfer, and Discharge F621 Equal Practices Regardless of Payment Source 483.15(b)(1)-(3)(c)(9) not applicable in CLCs

483.15 Admission, Transfer, and Discharge F622 Transfer and Discharge Requirements 483.15(c)(1)(i)(ii)(2)(i)-(iii) not applicable in CLCs, VHA Handbook outlines admission/dischsrge criteria to and from CLC

483.15 Admission, Transfer, and Discharge F623 Notice Requirements Before Transfer/Discharge 483.15(c)(3)-(6)(8) state specifc; not federal

483.15 Admission, Transfer, and Discharge F624 Preparation for Safe/Orderly Transfer/Discharge 483.15(c)(7) per directive upon approval of policy

483.15 Admission, Transfer, and Discharge F625 Notice of Bed Hold Policy Before/Upon Transfer 483.15(d)(1)(2) per directive upon approval of policy

483.15 Admission, Transfer, and Discharge F626

Permitting Residents to Return to Facility 483.15(e)(1)(2) not applicable in CLCs, VHA Handbook outlines admission/dischsrge criteria to and from CLC

483.20 Resident Assessments F640

Encoding/Transmitting Resident

Assessment 483.20(f)(1)-(4) CLC transmits to Austin

483.20 Resident Assessments F644

Coordination of PASARR and

Assessments 483.20(e)(1)(2) not applicable in CLCs

483.20 Resident Assessments F645 PASARR Screening for MD & ID 483.20(k)(1)-(3) not applicable in CLCs

483.20 Resident Assessments F646 MD/ID Significant Change Notification 483.20(k)(4) not applicable in CLCs

483.30 Physician Services F710

Resident's Care Supervised by a

Physician 483.30(a)(1)(2) The VA recognizes NPs as LIPs.

483.35 Nursing Services F728

Facility Hiring and Use of Nurse

Aide 483.35(d)(1)-(3) not applicable, CLCs are part of a larger complex medical institution and process, credentialing, privilaging, and hiring survyed under different entity

483.35 Nursing Services F729

Nurse Aide Registry Verification, Retraining 483.35(d)(4)-(6) not applicable in CLCs

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments

483.35 Nursing Services F730

Nurse Aide Perform Review – 12

Hr/Year In‐ service 483.35(d)(7) not applicable in CLCs

483.35 Nursing Services F731

Waiver‐Licensed Nurses 24

Hr/Day and RN Coverage 483.35(e)(1)-(7)(f)(1)(2) not applicable in CLCs

483.35 Nursing Services F732

Posted Nurse Staffing

Information 483.35(g)(1)-(4) not applicable in CLCs

483.50 Laboratory, Radiology, and Other Diagnostic Services F770 Laboratory Services 483.50(a)(1)(i) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F771 Blood Blank and Transfusion Services 483.50(a)(1)(ii) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F772

Lab Services Not Provided On‐

Site 483.50(a)(1)(iv) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F774

Assist with Transport

Arrangements to Lab Svcs 483.50(a)(2)(iii) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F775

Lab Reports in Record‐Lab

Name/Address 483.50(a)(2)(iv) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F776 Radiology/Other Diagnostic Services 483.50(b)(1)(i)(ii) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F778

Assist with Transport

Arrangements to Radiology 483.50(b)(2)(iii) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.50 Laboratory, Radiology, and Other Diagnostic Services F779

X‐Ray/Diagnostic Report in

Record‐Sign/Dated 483.50(b)(2)(iv) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.60 Food and Nutrition

Services F811

Feeding Asst ‐

Training/Supervision/Resident 483.60(h)(1)-(3) currently not a supported practice in CLCs

483.65 Specialized

Rehabilitative Services F826

Rehab Services‐ Physician

Order/Qualified Person 483.65(b) not applicable, CLCs are part of a larger complex medical institution and process, credentialing, privilaging, and hiring survyed under different entity

483.70 Administration F835 Administration 483.70 not applicable in CLCs

483.70 Administration F837 Governing Body 483.70(d)(1)-(3) not applicable in CLCs

483.70 Administration F843 Transfer Agreement 483.70(j)(1)(2) not applicable in CLCs

483.70 Administration F844 Disclosure of Ownership Requirements 483.70(k)(1)-(3) not applicable in CLCs

483.70 Administration F845 Facility closure‐Administrator 483.70(l)(1)-(3) not applicable in CLCs

483.70 Administration F846 Facility closure 483.70(m) not applicable in CLCs

483.70 Administration F849 Hospice Services 483.70(o)(1)-(4) not applicable in CLCs

483.70 Administration F850 Qualifications of Social Worker >120 Beds 483.70(p)(1)(2) not applicable, CLCs are part of a larger complex medical institution and process, credentialing, privilaging, and hiring survyed under different entity

483.70 Administration F851 Payroll Based Journal 483.70(q)(1)-(5) not applicable in CLCs

483.85 Compliance and Ethics

Program F895 Compliance andEthics Program 483.85(a)-(e) not applicable, CLCs are part of a larger complex medical institution and process, service survyed under different entity

483.95 Training Requirements F947 Required In‐Service Training for Nurse Aides 483.95(g)(1)-(4) not applicable in CLCs

483.95 Training Requirements F948 Training for Feeding Assistants 483.95(h) currently not a supported practice in CLCs

Regulatory Groupings Tag # (As of

Nov. 28, 2017)

SQC Tag?

X = Yes Tag Title CFR

Standard(s) (CMS, VHA, N/A)

Comments