Long Term Care

Last updated 3/3/10, 11:30 a.m. CT


Comprehensive Accreditation Manual for Long Term Care (CAMLTC)
Standards Improvement Initiative (SII): Changes to 2010 CAMLTC
Changes Made to the 2009 CAMLTC


Standards Improvement Initiative (SII): Changes to 2010 CAMLTC
The Updates
Requirements for Accreditation
Accreditation Participation Requirements (APR)
Environment of Care (EC)
Emergency Management (EM)
Human Resources (HR)
Infection Prevention and Control (IC)
Information Management (IM)
Leadership (LD)
Life Safety (LS)
Medication Management (MM)
National Patient Safety Goals (NPSG)
Provision of Care, Treatment, and Services (PC)
Performance Improvement (PI)
Record of Care, Treatment, and Services (RC)
Rights and Responsibilities of the Individual (RI)
Waived Testing (WT)
Policies, Procedures, and Other Information
The Accreditation Process (ACC)
Sentinel Events (SE)
The Joint Commission Quality Report (QR)
Simplifying Compliance Activities (SCA)
Medicare/Medicaid Certification-Based Long Term Care Accreditation Standards (MC)
Required Written Documentation (RWD)
Early Survey Policy Option (ESP)
Staffing Effectiveness Indicators (SEI)


The Updates

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Accreditation Participation Requirements (APR)

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Environment of Care (EC)

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Emergency Management (EM)

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Human Resources (HR)

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Infection Prevention and Control (IC)

Clarification on Reducing Infection Risks Associated with Medical Equipment, Devices, and Supplies (IC) (10/09)

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Information Management (IM)

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Leadership (LD)

Staffing Effectiveness Standard Suspended (LD) (8/09)

Staffing Effectiveness Requirements (LD, PI) (1/10)

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Life Safety (LS)

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Medication Management (MM)

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National Patient Safety Goals (NPSG)

2010 National Patient Safety Goals (10/09)

Errata to NPSG Chapter as Published in 2010 Comprehensive Accreditation Manual (12/09)

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Provision of Care, Treatment, and Services (PC)

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Performance Improvement (PI)

Staffing Effectiveness Requirements (LD, PI) (1/10)

Correction to Criticality Tiers Published in Perspectives (PI) (3/10)

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Record of Care, Treatment, and Services (RC)

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Rights and Responsibilities of the Individual (RI)

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Waived Testing (WT)

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The Accreditation Process (ACC)

2010 Updates to Accreditation and Certification Decision Rules (8/09)

Shorter Time Frame for Second Survey Under the Early Survey Policy (9/09)

Correction to New Fraud and Abuse Accreditation Decision Rule (9/09)

Clarification on Conducting Extension Surveys (10/09)

Revision to the ESC Tool on Secure Extranet (10/09)

Decision Rule for Preliminary Denial of Accreditation Eliminated (12/09)

New Preliminary Denial of Accreditation Process (12/09)

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Sentinel Events (SE)

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The Joint Commission Quality Report (QR)

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Simplifying Compliance Activities (SCA)

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Medicare/Medicaid Certification-Based Long Term Care Accreditation Standards (MC)

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Required Written Documentation (RWD)

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Early Survey Policy Option (ESP)

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Staffing Effectiveness Indicators (SEI)

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Changes Made to the 2009 CAMLTC (see above for changes made after implementation of the 2010 manual)
The Updates
The Accreditation Process
Sentinel Events
National Patient Safety Goals
The Joint Commission Quality Report
Accreditation Participation Requirements (APRs)
Standards, Rationales, Elements of Performance, and Scoring
 Section 1: Patient-Focused Functions
  Ethics, Rights, and Responsibilities (RI)
  Provision of Care, Treatment, and Services (PC)
  Medication Management (MM)
  Surveillance, Prevention, and Control of Infection (IC)
 Section 2: Organization Functions
  Improving Organization Performance (PI)
  Leadership (LD)
  Management of the Environment of Care (EC)
  Life Safety (LS)
  Management of Human Resources (HR)
  Management of Information (IM)
Medicare/Medicaid Certification-Based LTC Accreditation Standards
Performance Measurement and the ORYX Initiative
Simplifying Compliance Activities


The Updates

2006 Update (published in Fall 2005) Table of Changes

2006 Update 1 Table of Changes

2006 Update 2 Table of Changes

2007 Update 1 Table of Changes

2007 Update 2 Table of Changes (revised)

2008 Update 2 Table of Changes

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The Accreditation Process

2008 Accreditation Decision Rules for All Programs (8/07)

2008 Thresholds for Conditional Accreditation/Certification and Preliminary Denial of Accreditation/Certification (12/07)

Clarification on Details of Elimination of Four-Month Track Record Requirements Decision (1/08)

Methodology for Conducting Unannounced Surveys Within an 18-39 Month Window (4/08)

Inclusion of a Clarification Validation Survey as Part of the Appeal Process (5/08)

Time Limits Approved for Organizations to Eliminate an Immediate Threat to Life Situation (5/08)

Improvements to the Decision Process (8/08)

10-Day Clarification Time Frame (8/08)

2009 Accreditation Decision Rules (8/08)

Correction to Accreditation Decision Rule CON02 (9/08)

How SII May Affect Your PPR (10/08)

Modifications to the Electronic Statement of Conditions™ for States Requiring Suspension of Testing Activities (10/08)

New Accreditation Decision Rule for Long Term Care (10/08)

Corrections to a Few Accreditation Decision Rule 'Links' (11/08)

Remaining Component to the 2009 Accreditation Decision Methodology, Including Thresholds (12/08)

Clarification for Pediatric Emergency Medications and Immediate Threat to Life (1/09)

Update on the 2009 Decision Process (2/09)

Updated Deposit and Fee Policies (2/09)

Additional Unannounced Survey Exceptions and Advance Notice Provision (3/09)

Approved: Revisions to the Public Information Policy (4/09)

Approved: An Extension for Extension Surveys (5/09)

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Sentinel Events

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National Patient Safety Goals

The 2008 National Patient Safety Goals (7/07)

The Joint Commission Announces the 2009 National Patient Safety Goals and Requirements (7/08)

NPSG.07.04.01 Applies to Medicare/Medicaid Certification-Based Long Term Care (9/08)

Errata to 2009 Requirements for LS and NPSG (2/09)

NPSG 8 (Medication Reconciliation) Will Not Be Scored in 2009 (3/09)

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The Joint Commission Quality Report

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Accreditation Participation Requirements (APRs)

Requirement for Accredited Nursing Homes to Notify the Joint Commission When They Become a Special Focus Facility (APR 1, EP 3) (6/08)

The Joint Commission Suspends Standard MS.1.20 Implementation Date; Implementation Task Force to Continue Work on Medical Staff Standard Revision (7/08)

Errata for All 2009 Accreditation and Certification Manuals (APR) (5/09)

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Standards, Rationales, Elements of Performance, and Scoring

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Section 1: Resident-Focused Functions

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Ethics, Rights, and Responsibilities (RI)

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Provision of Care, Treatment, and Services (PC)

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Medication Management (MM)

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Surveillance, Prevention, and Control of Infection (IC)

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Section 2: Organization Functions

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Improving Organization Performance (PI)

Additional Scoring Changes for All 2009 Accreditation Manuals (LD, LS, PI) (6/09)

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Leadership (LD)

Revisions to Contracted Services Standard LD.3.50 (7/07)

Revised Scoring for All 2009 Accreditation Manuals (LD) (5/09)

Additional Scoring Changes for All 2009 Accreditation Manuals (LD, LS, PI) (6/09)

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Management of the Environment of Care (EC)

Correction to Standard EC.4.20, EP 4 (11/07)

Revision to Note for Standard EC.4.12, EP 6 (1/08)

Revisions to Fire-Safety Equipment Maintenance Standard EC.5.40, EP 14 (1/08)

Change in Compliance Expectation for Emergency Management Standards (6/08)

Modifications to the Electronic Statement of Conditions™ for States Requiring Suspension of Testing Activities (10/08)

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Life Safety (LS)

Errata to 2009 Requirements for LS and NPSG (2/09)

Additional Scoring Changes for All 2009 Accreditation Manuals (LD, LS, PI) (6/09)

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Management of Human Resources (HR)

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Management of Information (IM)

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Medicare/Medicaid Certification-Based LTC Accreditation Standards

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Performance Measurement and the ORYX Initiative

ORYX Requirements for Three Programs Rescinded for 2010 (11/09)

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Simplifying Compliance Activities

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