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Each Appendix is a separate file that can be accessed directly from the SOM. Appendices Table of Contents, as applicable. • The appendices are in PDF format The State Operations Manual (SOM for long-term care) contains the primary survey and certification rules and guidance from the Centers for Medicare and The CMS State Operations Manual (SOM) provides CMS policy regarding survey and certification activities. Surveyors assess the hospital's compliance with the Appendix A Interpretive Guidelines And Survey Procedures - Hospital Table of Contents. Related to Health Care Financing Administration Transmittal 21. Purpose:. State Operations Manual. Appendix I – Survey Procedures and Interpretive. Guidelines for Life Safety Code Surveys - (Rev. 1, 05-21-04). State Operations Manual Appendix W - Survey Protocol, Regulations and Interpretive Guidelines for Centers for Medicare and Medicaid Services (CMS).