SOM - Chapter 2

State Operations Manual: Chapter 2 - The Certification Process

 
 Date PostedPublication
8/30/2011 §2000 - Certification Surveys - Citations and Responsibility 
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8/30/2011 §2002 - Meaning of Providers and Suppliers 
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10/28/2014 §2003 - SA Identification of Potiential Providers and Suppliers 
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10/28/2014 §2004 - Provider-Based Determinations 
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10/28/2014 §2005 - Medicare Health Care Provider / Supplier Enrollment 
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10/28/2014 §2008 - Prioritizing SA Survey Workload - Initial Surveys and Recertifications 
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8/30/2011 §2010 - Ascertaining Compliance With Civil Rights Requirements 
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8/30/2011 §2012 - SA Identifying Eligible Providers and Suppliers 
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10/28/2014 §2016 - Readmission to Medicare or Medicaid Program After Involuntary Termination - Reasonable Assurance 
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8/30/2011 §2017 - Readmission Following Voluntary Termination of Program Participation 
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8/30/2011 §2018 - Reinstatement Following Termination of Swing-Bed - Approval 
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8/30/2011 §2020 - Hospitals - Defintion and Citations 
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10/28/2014 §2021 - Non-Deemed Hospitals 
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10/28/2014 §2022 - Deemed Status: Hospitals Accredited by an Accrediting Organization with a CMS-Approved Medicare Hospital or Medicare Psychiatric Hospital Accreditation Program 
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8/30/2011 §2024 - Hospital Merger / Multiple Campus Criteria 
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8/30/2011 §2026 - Certfication of Parts of Institutions as Hosptals 
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8/30/2011 §2030 - Temporary Waivers Applicable to Rural Hospitals 
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8/30/2011 §2034 - Time Limit on Temporary Waiver 
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8/30/2011 §2036 - Definition, Authority and Requirements for Hospital Providers of Extended Care Services ("Swing-Beds") 
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8/30/2011 §2037 - Requirements Assessed Prior to Survey for Swing-Bed Approval 
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8/30/2011 §2038 - Survey Procedures for Swing-Bed Approval 
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8/30/2011 §2039 - Post-Survey Procedures for Swing-Bed Hospitals 
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8/30/2011 §2040 - RO Approval Procedures for Swing-Bed Approval 
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8/30/2011 §2042 - Psychiatric Hospitals 
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10/28/2014 §2044 - Psychiatric Hospitals and Deemed Status 
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8/30/2011 §2048 - Distinct Part Psychiatric Hospital 
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8/30/2011 §2050 - Medical-Surgical Unit of Psychiatric Hospitals 
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8/30/2011 §2052 - Nonparticipating Emergency Hospitals 
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10/28/2014 §2053 - Medicaid-Only Hospitals 
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8/30/2011 §2054 - Religious Nonmedical Health Care Institutions (RNHCIs) 
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12/14/2011 §2080 - Hospice - Citations and Description 
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12/14/2011 §2081 - Revoking Election of Hospice Care 
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12/14/2011 §2082 - Discharge from Hospice Care 
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12/14/2011 §2083 - Hospice Regulations and Non-Medicare Patients 
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12/14/2011 §2084 - Hospice Inpatient Services  
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8/30/2011 §2085 - Operation of Hospice Across State Lines 
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12/14/2011 §2086 - Hospice Change of Address 
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9/26/2011 §2087 - Simultaneous Surveys 
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9/26/2011 §2088 - Multiple Locations 
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12/14/2011 §2089 - Survey Requirements When Hospice Provides Care to SNF/NF or ICF/MR 
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8/30/2011 §2130 - ICFs/MR - Citations and Description 
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8/30/2011 §2134 - Distinct Part ICF/MR 
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8/30/2011 §2138 - Approval Procedures for ICFs/MR 
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8/30/2011 §2139 - Assessment of ICFs/MR Based on CoPs for Active Treatment 
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8/30/2011 §2140 - Waiver and/or Variance of ICF/MR Requirements 
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8/30/2011 §2141 - Time-Limited Certifications - ICFs/MR 
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8/30/2011 §2160 - Purpose of Certifying §§1861(e)(1) and 1819(a)(1) of the Act Status of Hospitals and SNFs 
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8/30/2011 §2162 - Defining Hospital for Spell of Illness, DME, and Home Health Benefit Purposes 
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8/30/2011 §2164 - When to Make Spell of Illness Certification 
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8/30/2011 §2166 - Criteria for Certifying §1819(a)(1) of the Act Status of LTC Facilities Other than SNFs 
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8/30/2011 §2168 - Additional Development Required for Spell of Illness Certifications 
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12/22/2014 §2180 - HHA - Citations and Description 
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12/22/2014 §2182 - Organization of HHA 
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12/22/2014 §2183 - Separate Entities 
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12/22/2014 §2184 - Operation of HHAs Cross State Lines 
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9/8/2015 §2185 - HHA - Change of Address 
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12/22/2014 §2186 - Health Facility-Based HHAs 
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8/30/2011 §2188 - Survey of State-Operated HHAs 
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8/30/2011 §2194 - Surveying HMOs and HHAs Providing Home Health Services 
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12/22/2014 §2195 - Guidelines for Determining Survey Frequency 
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12/22/2014 §2197 - Surveyor Worksheets 
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1/27/2015 §2202 - Outcome and Assessment Information Set (OASIS) Requirements 
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8/30/2011 §2210 - ASCs - Citations and Description 
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8/30/2011 §2240 - RHC - Citations and Description 
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4/29/2015 §2242 - Conditions to be Assessed Prior to Scheduling RHC Survey 
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8/30/2011 §2244 - Preparing for RHC Survey 
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8/30/2011 §2246 - Clinic's Request to Provide Visiting Nurse Services 
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8/30/2011 §2248 - Clinic's Request for Waiver of Staffing Requirements 
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4/29/2015 §2249 - RO Notification of RHC Initial Certification Approval 
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8/30/2011 §2250 - Community Mental Health Centers (CMHC) - Citations and Descriptions 
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8/30/2011 §2252 - Certification Process 
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8/30/2011 §2254 - CAHS (Critical Access Hospitals) 
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8/30/2011 §2255 - SA Procedures for CAH Approval 
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8/11/2015 §2256 - RO Procedures for CAH Approval 
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8/30/2011 §2257 - CAH Anti-Dumping Requirements 
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8/30/2011 §2258 - Advance Directive Requirements for CAHS 
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8/30/2011 §2259 - Procedures for Processing CAH Swing-Bed Applications 
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8/30/2011 §2260 - Survey Procedures for Swing-Bed Approval 
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8/30/2011 §2261 - Post-Survey Procedures for Swing-Bed CAHS 
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8/30/2011 §2262 - RO Approval Procedures for Swing-Bed Approval 
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10/22/2018 §2270 - Medicare and ESRD 
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10/22/2018 §2271 - General Requirements for In-Center and Home Dialysis Program 
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10/22/2018 §2272 - ESRD Facility Classification 
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10/22/2018 §2273 - Dialysis Modalities and Dialysis Related Services 
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10/22/2018 §2274 - ESRD Survey and Certification Forms 
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10/22/2018 §2276 - SA Control of Form CMS-3427 
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10/22/2018 §2278 - ESRD Survey Procedures 
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10/22/2018 §2279 - ESRD CMS Certification Numbers 
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10/22/2018 §2280 - ESRD Survey Activities 
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10/22/2018 §2281 - Waivers 
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10/22/2018 §2282 - RO Use of Provider Tie-In Notice, Form CMS-2007, for Suppliers of ESRD Program Services (Exhibit 156) 
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10/22/2018 §2283 - Termination Procedures 
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10/22/2018 §2284 - Specialized Areas of ESRD Oversight 
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10/22/2018 §2286 - ESRD Network Participation and Data Submission 
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10/22/2018 §2287 - ESRD Patient Care Technician (PCT) 
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10/22/2018 §2288 - Infection Control Considerations 
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3/26/2013 §2290 - OPT/OSP - Providers of Outpatient Physical Therapy and Speech-Language Pathology Services - Citations 
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11/5/2015 §2292 - Types of Organizations, Who May Provide Outpatient Physical Therapy and Speech-Language Pathology Services, Specified in §§485.701-485.729 
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3/26/2013 §2294 - Changes of Address 
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3/26/2013 §2296 - Medicare Approved Sites of Service Provision 
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11/5/2015 §2298 - Extension Locations for Rehabilitation Agencies 
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11/5/2015 §2300 - Services at Other Locations Such as a Patient's Private Residence, Assisted Living or Independent Living Facility 
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3/26/2013 §2302 - CMS-381 Model Letter Requesting Identification of Extension Locations 
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3/26/2013 §2304 - Operation of an Organization on the Premises of a Supplier-Provider 
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3/26/2013 §2306 - When a Rehabilitation Agency's Extension Location Becomes Its Primary Site 
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3/26/2013 §2308 - Relocations of Providers of Outpatient Physical Therapy and Outpatient Speech-Language Pathology Services Concurrent with CHOWs 
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8/30/2011 §2360 - CORF - Citations and Description 
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8/30/2011 §2362 - Scope and Site of Services 
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8/30/2011 §2364 - CORF's Relationship with Other Providers or Suppliers 
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8/30/2011 §2366 - Conversion of OPT/OSP to CORF 
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8/30/2011 §2420 - Supplier's of Portable X-Ray Services - Citations 
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8/30/2011 §2422 - Location of Portable X-Ray Service 
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8/30/2011 §2424 - Suppliers Using Improperly Labeled or Post-1974 Equipment 
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8/30/2011 §2460 - Mammography 
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8/30/2011 §2470 - LSC - Citations and Applicability 
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8/30/2011 §2472 - Life Safety Code (LSC) Surveys 
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8/30/2011 §2474 - Fire Safety Survey Report Forms (Form CMS-2786 Series) 
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8/30/2011 §2476 - Fire Safety Survey Report - Short Form, Form CMS-2786S 
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8/30/2011 §2478 - Application of Fire Safety Evaluation System (FSES) 
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8/30/2011 §2480 - LSC Waivers 
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8/30/2011 §2482 - Technical Bulletins 
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8/30/2011 §2490 - Compliance with §504 of the Rehabilitation Act of 1973, as Amended 
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8/30/2011 §2496 - Utilization Review (UR) 
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8/30/2011 §2700 - Conducting Initial Surveys and Rescheduled Resurveys 
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8/30/2011 §2702 - SA Conducting Unscheduled Surveys 
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8/30/2011 §2704 - SA Presurvey Preparation 
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10/28/2014 §2705 - SA Survey Team Workload 
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8/30/2011 §2706 - SA Survey Team Composition 
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8/30/2011 §2708 - Facility Refuses to Allow Survey 
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8/30/2011 §2710 - Reviewing Forms at Beginning of Survey 
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8/30/2011 §2712 - Use of Survey Protocol in the Survey Process 
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8/30/2011 §2713 - During Survey 
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8/30/2011 §2714 - Interviewing Key Personnel 
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8/30/2011 §2715 - Interviewing Residents Using the LTC Survey Process 
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8/30/2011 §2716 - Special Survey of Pharmaceutical Service Requirements in SNFs, NFs, and ICFs / MR 
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8/30/2011 §2718 - Assistance in Surveying Psychiatric Hospitals 
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8/30/2011 §2720 - Completing the Survey Report 
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8/30/2011 §2722 - Preparation for Exit Conference (Excluding SNFs and NFs) 
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8/30/2011 §2723 - Citing Deficiencies in SNFs and NFs 
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6/13/2016 §2724 - Exit Conference 
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8/30/2011 §2726 - Summary of SA Certification Actions Performed After Survey 
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6/13/2016 §2727 - Limitations on Technical Assistance Afforded by Surveyors 
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8/30/2011 §2728 - Statement of Deficiencies and Plan of Correction, Form CMS-2567 
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8/30/2011 §2732 - Follow-Up on PoCs 
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8/30/2011 §2734 - SA Evaluation of Compliance 
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8/30/2011 §2736 - The Outcome-Oriented Survey Process 
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8/30/2011 §2760 - Forwarding Certification to RO 
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8/30/2011 §2762 - Medicare / Medicaid Certification and Transmittal, Form CMS-1539 
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10/28/2014 §2764 - SA Completion Instructions for Certification and Transmittal, Form CMS-1539 (Exhibit 9) 
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8/30/2011 §2765 - Intermediary Tie-In Activities 
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8/30/2011 §2766 - Spell of Illness Supplement, Form CMS-1539A (Exhibit 10) 
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8/30/2011 §2772 - Packet of Documentation Attached to Certification and Transmittal by SA 
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8/30/2011 §2774 - Routing of Medicaid-Only Certifications 
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8/30/2011 §2776 - RO Requests for Additional Information 
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10/28/2014 §2777 - RO Review of SA Certifications 
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10/28/2014 §2778 - Objectives of RO Certification Review 
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11/8/2016 §2779 - RO Assignment of CMS Certification Numbers  
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10/28/2014 §2780 - Effective Date of Provider Agreement, Form CMS-1561, and Supplier Approval 
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8/30/2011 §2781 - RO Countersigning Provider Agreement 
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8/30/2011 §2782 - RO Notice of Acceptance 
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8/30/2011 §2783 - Provider Tie-In Notice (Form CMS-2007) 
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8/30/2011 §2784 - Effective Date of Certification of Coverage for Suppliers of Services 
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8/30/2011 §2800 - Strikes at Participating Facilities 
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4/30/2014 §2810 - HHA - Organ Procurement Organizations (OPOs) - Citations - Statutory Authority 
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4/30/2014 §2811 - OPO Requirements for Certification 
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7/9/2018 §2812 - OPO Designation Requirements 
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4/30/2014 §2813 - Re-Certification Cycle 
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4/30/2014 §2814 - Change in Control/Ownership or Service Area 
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4/30/2014 §2815 - De-Certification and Competition 
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4/30/2014 §2817 - Voluntary Termination of an Agreement 
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4/30/2014 §2818 - Involuntary Termination and Non-Renewal of an Agreement 
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4/30/2014 §2819 - Appeals 
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4/30/2014 §2820 - Outcome Measures/Data Reporting: Not Reviewed On Site 
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4/30/2014 §2821 - Information Management 
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8/30/2011 §2825 - Federally Qualified Health Centers (FQHCs) - Citations and Description 
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8/30/2011 §2826 - RO Approval Process for FQHCs 
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1/20/2015 §2830 - Psychiatric Residential Treatment Facilities (PRTF) - Citations and Definitions 
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1/20/2015 §2831 - Determination-Making Authority 
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1/20/2015 §2832 - Survey Agency, State Medicaid Agency, and PRTF Responsibilities & Obligations 
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1/20/2015 §2833 - Survey Process 
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1/20/2015 §2834 - Other Applicable SOM Sections 
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