This page compiles essential federal and state regulatory resources to help nursing homes understand and navigate applicable requirements. HSAG is not a regulatory agency and does not issue or enforce regulations.
Federal Resources
- Certification and Compliance (CMS)
- Quality, Safety, and Oversight (QSO) (CMS)
- QSO Policy and Memos to State and CMS Locations (CMS)
- QSO-25-14-NH Revised Long-Term Care Surveyor Guidance (CMS)
- Appendix PP State Operations Manual: Interpretive Guidelines for Long-Term Care Facilities (CMS)
- Critical Elements Pathways (CEP) (CMS)
- Survey Resources (ZIP)
- Once the ZIP file opens, the CEPs are located in a file named "LTC Survey Pathways"
- Reform of Requirements for Long-Term Care Facilities (CMS)
- Federal and State Nursing Home and Assisted Living Regulations (Seniorliving.org)
- The National Consumer Voice for Quality Long-Term Care: Get Help (The Consumer Voice)
- Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User's Manual (Version 1.20.1, October 2025) (CMS)
- Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide (April 2026) (CMS)
- Minumum Dats Set (MDS) 3.0 Quality Measures User's Manual (Version 18.0, January 2, 2026) (CMS)
- Skilled Nursing Facility Quality Reporting Program (QRP) Measure Calculations and Reporting User's Manual (Version 7.0, October 1, 2025) (CMS)
CMS = Centers for Medicare & Medicaid Services
State Resources
- Arizona Administrative Code (Arizona Secretary of State)
- Arizona Title 9 Licensing (Arizona Secretary of State)
- Arizona Compliance Survey Process (ADHS)
- Arizona Long-Term Care Licensing (ADHS)
ADHS = Arizona Department of Health Services
Cal/OSHA enforces and governs workplace safety standards. Title 22 addresses licensing and resident care. Title 8 addresses workplace safety for employees.
- Title 8 Regulations (California Code of Regulations)
- Aerosol Transmissible Diseases (California Code of Regulations)
- Injury and Illness Prevention (California Code of Regulations)
- Violence Prevention in Health Care (California Code of Regulations)
- Heat-Illness Prevention in Outdoor Places of Employment (California Code of Regulations)
- California All Facility Letters (AFL) (CDPH)
- Licensing and Certification Regulations (CDPH)
- Title 22: Division 5. Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies (Thomson Reuters Westlaw)
- California Health Alert Network (CAHAN) Notifications (CDPH)
Cal/OSHA = California Division of Occupational Safety and Health | CDPH = California Department of Public Health
- Hawaii Revised Statutes, Chapter 94 (Hawaii State Department of Health)
- Medical Advisory: Interim Return-to-Work (RTW) Guidance for Healthcare Personnel with COVID-19, Influenza, Respiratory Syncytial Virus (RSV), and Other Acute Viral Respiratory Infections (May 22, 2026) (Hawaii State Department of Health)
- Healthcare Care Quality and Compliance (Nevada Health Authority)
- 10 GCA Chapter 7 Nursing Home Regulations (GCA Health and Safety)