Revised Quality of Care Guidance at F309, including Pain Management as Part of Appendix PP SOM

Revised guidance for long-term care surveyors at F309, Quality of Care, including a new general investigative protocol and new pain management guidance and investigative protocol will be effective March 31, 2009; The advance copy of this guidance and training materials are to be used to train all surveyors who survey nursing homes by the implementation date; Removed hospice and dialysis survey protocol language from Appendix P and inserted into F309; Removed weight loss investigative protocol from Appendix P due to the June 2008 issuance of F325 investigative protocol; Deleted guidance requiring paper copy storage of Minimum Data Set in homes with electronic records at Tag F286, 483.20(d), Use; and Removed demand billing survey process at Appendix P, Part VII and inserted new procedure at Task 5C.