CMS finalized changes to the requirements for the director of food and nutrition services as well as physical environment.

• The agency posted a revised advanced copy of Appendix PPas an attachment to QSO-22-19-NH including new regulatory language.
• These changes are effective on October 1, 2022.

483.60(a)(2)(i) Food and nutrition services (page 605)

• CMS is adding allowance for experience in the position as one of the ways to qualify for the position of the director of food and nutrition services.
• Specifically, an individual who, on the effective date of the final rule (October 1, 2022), has two or more years of experience in the position of director of food and nutrition services in a nursing facility setting and has completed a course of study in food safety and management by no later than October 1, 2023, along with the other requirements set out at § 483.60(a)(2), is qualified to be the director of food and nutrition services.

483.90(a)(1)(iii) Physical environment (page 794)

• CMS is adding allowance for existing facilities that are Medicare- or Medicaid-certified before July 5, 2016, and the facility has previously used the Fire Safety Evaluation System for compliance (to determine equivalent fire protection levels), the facility may use scoring values in the Mandatory Values Chart (which is consistent with the 2001 FSES mandatory values) when determining compliance for containment, extinguishment, and people movement requirements.