QSO-22-19-NH was issued on June 29, 2022, by the Centers for Medicare and Medicaid Services (CMS). This released Updated Guidance for Nursing Home Resident Health and Safety (Updated Guidance) as part of the Phase 2 and 3 Requirements for Participation (ROP). Significant revisions to the ROPS were originally published in 2016 and have been implemented and updated in a multi-year phase-in process since that issuance. The Updated Guidance focuses on quality of care and life as part of an ongoing effort to complete the final two phases of the ROP revisions and to reinforce some of the Biden administration’s efforts to protect seniors by improving quality and safety of nursing homes. The Updated Guidance announced the “Advanced Copy” issuance of Appendix PP of the State Operations Manual (SOM) for State Survey Agencies (SAs). The SA surveyors will begin utilizing this guidance on October 24, 2022. Providers are encouraged to review the updated guidance, utilize the training resources that are publicly available and incorporate revisions into applicable policies, procedures and processes. Due to the significant number of changes made by the Updated Guidance, selected areas are being discussed in this advisory. Reference the six-page QSO for additional resources and information.