CMS published Transmittals 156 and 157 on June 10, 2016 with an immediate effective date. No regulatory changes were observed but each of the referenced tags had additional guidance to surveyors for citing deficiencies.  Both of these revisions focus on more accurate assessment and consideration of psychosocial impact (actual or potential) from related deficiencies.  Transmittal 156 can be found here and Transmittal 157 can be found here.

• Transmittal 156 revises the instructions to surveyors in section IV, subsection E of Appendix P, Psychosocial Outcome Severity Guide, in order to provide additional information to surveyors about assessing for psychosocial harm
• Transmittal 157 outlines revisions to multiple F-Tags in Appendix PP of the State Operation Manual. These revisions were effective immediately. 
  

A memo produced for VHCA from Chiles Healthcare Consulting summarizing the two transmittals can be accessed here.