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Key Revisions to CMS' State Operations Manual Include Changes to Discharge On September 30, 2019, Centers for Medicare and Medicaid Services (CMS)Centers for Medicare and Medicaid Services. Medicare Provider Memos State Operations Manual. CMS Updates SOM, Chapters 1-3 The State Operations Manual (SOM for long-term care) contains the primary survey and certification rules and guidance from the Centers for Medicare and State Operations Manual. Appendix PP - Guidance to Surveyors for. Long Term Care Facilities. Table of Contents. (Rev. 173, 11-22-17). SUMMARY OF CHANGES: CMS, State Operations Manual, Appendix A—Survey Protocol, Regulations and Interpretive Guidelines for Hospitals, pp. • The CMS State Essential CMS forms to download and use; Guidance for policymaking; Risk management advice. Published: March 2019. Page Count: 810. ISBN: 978-1-68308-963 The Centers for Medicare and Medicaid Services (CMS) has issued the revised State Operations Manual for Long-Term Care Facilities Appendix PP Guidance. CMS.gov Centers for Medicare & Medicaid Services. Search. Site 100-07. Publication #. 100-07. Title. State Operations Manual. Downloads.