Guidance for Hospitals, Critical Access Hospitals (CAHs) and Ambulatory Surgical Centers (ASCs) Related to Various Rules Reducing
• Various Burden Reduction Regulations Adopted:
• On October 24, 2011, the Centers for Medicare & Medicaid Services (CMS) published a final rule revising the ASC Patient
Rights regulation at 42 CFR 416.50, effective December 23, 2011 (76 FR 65886).
• On November 30, 2011, CMS published the Hospital Outpatient Prospective Payment System rule, effective January 1, 2012 (76
FR 74122). The rule included revisions to 42 CFR 489.20(w), governing required notice to patients by hospitals and CAHs that
do not have an doctor of medicine (MD) or doctor of osteopathy (DO) present in the hospital or CAH at all times.
• On May 16, 2012, CMS published two final rules (77 FR 29002 & 77 FR 29034) which included provisions:
• For Hospitals: Revisions of the Conditions of Participation (CoPs) concerning governing body, patient’s rights, medical
staff, nursing services, medical records, pharmaceutical services, infection control, outpatient services and transplant center
organ recovery and receipt.
• For CAHs: Revisions of the CoPs concerning definitions, personnel qualifications, physical plant and environment, and surgical
• For ASCs: Revision of the Condition for Coverage (CfC) for environment.
• State Operations Manual (SOM) Revisions: Appendices A (hospitals), W (CAHs) and L (ASCs) are revised to reflect these final
rules, except that transplant center guidance will be updated separately. In addition, we are taking this opportunity to make
minor technical corrections to Appendix L.
• Automated Survey Processing Environment (ASPEN) Changes: ASPEN regulatory text and tags have been updated for hospitals
and CAHs. ASC updates will be made in ASPEN at a later date. Some tags have been renumbered, consolidated or deleted. A crosswalk
from the old to the new tags is provided.