Deficiencies are based on a violation of the statute or regulations, which, in turn, is to be based on observations of the provider's performance or practices. You may be trying to access this site from a secured browser on the server. SAs may enter into sub-agreements or contracts with the State Fire Marshal offices or other State agencies responsible for enforcing State fire code requirements. Official websites use .govA Y{SF{zx{~Z^T#TNDtiF0xh r,!P",},uqqt5Z5i,_F>Aw[40fXT8#M id+P'zvyg3dz0o`|^!Ao PK ! C\ 7I?_ \#KnXG!zBKXXv/>sVw1z;^q\_eIRCO\0l GT:8]Ay3 "go3\^MOl6g;|{_1KuIzKK!}1N6;AY`yP!0$fF```P!;t3KY>@ %%EOF Agency for Health Care Administration ASPEN: Regulation Set (RS) Printed 01/17/2023 Page 1 of 100 Aspen State Regulation Set: K 6.01 Life Safety Code for NH Title INITIAL COMMENTS Type Memo Tag ST - K0000 - INITIAL COMMENTS . 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Life Safety Code & Health Care Facilities Code (HCFC), Quality, Safety & Oversight- Guidance to Laws & Regulations, Psychiatric Residential Treatment Facilities, Comprehensive Outpatient Rehabilitation Facilities, Religious Nonmedical Health Care Institutions, Appendix I of the State Operations Manual (PDF), Quality, Safety & Oversight - Enforcement, Life Safety Code & Health Care Facilities Code Requirements. 1. security or safety needs in accordance with 18.2.2.2.5 or 19.2.2.2.5. CMS partners with State Agencies (SA) to assess facilities for compliance with the LSC requirements. cT 3 word/document.xml}rHF;dhc6&$ means youve safely connected to the .gov website. These codes are a comprehensive set of requirements, which provide residents a high level of safety and security due to the nature of illness, impairment and the inability to self-evacuate in an emergency. Life Safety Code & Health Care Facilities Code (HCFC) Survey protocols and Interpretive Guidelines are established to provide guidance to personnel conducting surveys. Appendix PP Guidance to Surveyor for Long Term Care Facilities, 483.12- Freedom from Abuse, Neglect, and Exploitation, 483.15-Admission, Transfer, and Discharge, 483.30-Physician Services and 483.35 Nursing Services, 483.90-Physical Environment F919-Resident Call System, Quality, Safety & Oversight - General Information, Quality Safety & Oversight - Guidance to Laws & Regulations, CMS Quality Safety & Oversight memoranda, guidance, clarifications, and instructions to SSA and CMS Regional Offices, State Operations Manual-Survey and Enforcement Process for SNFs and NFs. Share sensitive information only on official, secure websites. Under these agreements, the designated State fire authority generally agrees to: In most cases, the SA schedules the LSC/HCFC survey to coincide with the health survey; however, the timing of the LSC/HCFC survey is left to the discretion of the SAs. The program also introduces and discusses AHCAs newly updated Emergency Preparedness Plan Best Practice Guide and Template. Set of construction documents approved by AHCA Sprinkler working drawings approved by AHCA Life safety plan (preferably reduced for convenient use) The AHCA Emergency Preparedness and Life Safety Committee specifically focuses on these areas. State Regulations AHCA: Health Quality Assurance Current Regulations in ASPEN -- Survey The tables below list the regulation sets used by surveyors when recording survey findings in the ASPEN program ( A utomated S urvey P rocessing EN vironment). During an inspection Agency surveyors review a sampling of clinical records, policies and procedures, staffing reports and other relevant documents. or The Agency for Health Care Administration's Division of Health Quality Assurance is responsible for the licensure and regulation of health care providers. ) Phase 3 of the Requirements of Participation (RoP) went into An official website of the United States government These regulations, combined with the findings, print as the CMS-2567 Form, which The AHCA regulatory team provides members guidance and resources to help understand the survey process and implement the requirements. .gov The Joint Commission requires healthcare facilities seeking accreditation to comply with Life Safety Code among other standards. or LIFE SAFETY CODE DOCUMENTATION REVIEW CHECKLIST Hospitals and Nursing Homes New Mexico - LSC 101, 2012 Edition . States may also require their own initial survey before permitting facilities to become operational and admit patients. Unreasonable Hardship/Waivers - The LSC and HCFC permit the authority having jurisdiction to determine the adequacy of protection provided for life safety from fire in accordance with the provisions of the LSC. They also conduct interviews with patients/residents, family members, staff, visitors, and/or volunteers. 0 This is a collaborative group, facilitated by NFPA staff, that includes CMS and other authorities having jurisdiction (AHJs) where code related issues can be discussed and consistent interpretations developed. ,ft"gx!F$N_CpaId){yvy?dr""zy6+"yXqgE6-GQ68bY>Tys&,OJ- The SAs or CMS approved Accreditation Organizations (AO) may recommend approval of waivers requested by providers, but only CMS Regional Offices (RO) may grant approval of waivers. Ask for a copy of the Life Safety Floor Plan of the building(s) 3. Use only qualified fire safety inspectors who have received CMS training in the performance of these surveys. The Secretary has delegated to CMS the authority to grant waivers of LSC and HCFC provisions for all facilities participating in Medicare and Medicaid. Additional resources andtools to help you navigate the ROP are available on ahcancalED, including, Requirements of Participation eCompetencies, Payroll Based Journal (PBJ) Mandatory Reporting, Quality Assurance/Performance Improvement (QAPI), Occupational Safety and Health Administration (OSHA), ________________________________________________________________________________________________________, Focus F-Tags: Guidance for ROP Phase 2 and 3, Phase 3 of the Requirements of Participation (RoP) went into These tools were initially developed by members of AHCA's Survey/Regulatory Committee and adapted for assisted living communities to assist providers in addressing adverse events and potential adverse events, documenting and tracking the steps they have taken, and identifying best practices for ongoing improvement. %PDF-1.7 % ,KiSBK_zDA*_KQZ+I;+I_q\I~Iq%},7Y>Kg~}9/x8Nb8xD[d%l2YyWxr-Y"KYX#|~lilUFs.Wu.T5?\"V:~KKGuMsqG*@W You may be trying to access this site from a secured browser on the server. AHCA/NCAL provides member support around fire safety and life safety issues by providing education, developing tools, offering consultation, and through on-going advocacy. Upon notification by CO, the RO advises the State authority that submitted the request whether the State code is acceptable in lieu of the LSC. Secure .gov websites use HTTPSA Providers can find Focus F-Tag weeklysummaries on this page. AHCA/NCAL participates in the International Code Council (building and fire codes) code development process and provides input to the Facility Guidelines Institute (FGI) in the development of the. Any alterations to the building that adhere to public health guide- With the input of the S&C Emergency Preparedness Stakeholder Communication Forum, CMS has compiled a list of useful national emergency preparedness resources to assist State Survey Agencies (SAs), their State, Tribal, Regional, local emergency management partners, and health care providers to develop effective and robust emergency plans. Life Safety and Emergency Preparedness are two critical regulatory compliance components that are consistently areas of survey focus. Share sensitive information only on official, secure websites. These materials have been updated as of 5/25/18 Email educate@ahca.org if you need assistance. Each week through October, AHCA will highlight a particular F-tag(s) to help providers better understandthe Phase 2 updates and Phase 3 new guidance. However, as the Centers for Medicare & National Fire Protection Association (NFPA) - The NFPA publishes the Codes and Standards CMS uses in determining compliance with the fire safety requirements of our regulations. Each regulation is assigned a tag number, followed by a summary of the requirement and details of why this requirement was not met. The program digs into specific compliance issues and outlines best practices and mitigation methods to keep you in compliance and avoid survey findings. You may be trying to access this site from a secured browser on the server. This helpful checklist serves as a vital tool to perform a annual inspection. The LSC and HCFC, which is revised periodically, is a publication of NFPA, which was founded in 1896 to promote the science and improve the methods of fire protection. Y!Q6F6]=#.f.>Z[bGq@t&8ve91 [Content_Types].xml ( n0EE'-E6@][Dq}Rp44 E9eX^||bEDahm!7C,(g\t,.7XN?r, & 6}Zl,+tUI9Blg\{"=q}|GSq? It covers construction, protection, and operational features designed to provide safety from fire, smoke, and panic. This Power Point presentation will provide the necessary information to inspect doors for safety. [jG#8>}gy|D_i?_w\N!Sj+X:?A# #R0cB@0 l xrL|~2Yk+DMj1:%36Tp8J+$&d@)t#|:9QY\htzHqYQy.|"L9j5]4u/0OOv@OF1v,zA'} Tarp?0W=1.%gj k *wI\-cqGwE5*Ui^%8ZKXTq&2 =M[stR-nwO~hZ~U/%\P{IA+|"DoMGU[`. Survey non-accredited hospitals, hospices, ASCs, SNFs, NFs, CAHs, RNHCIs, PACE , ESRD, and ICF/IIDs in accordance with schedules the SA furnishes; Survey accredited hospitals selected for validation surveys or surveyed as a result of a substantial allegation of an unsafe conditions; Complete the appropriate Fire Safety Survey Report (Form CMS-2786); Prepare statements of deficiencies and review Plans of Correction (Form CMS-2567); Make recommendations to the SA regarding facilities' compliance with program fire safety requirements; and. The tips provided are intended for reference only. Inspection Reports Frequently Asked Questions. lock DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES 01/2022 1 . )^v{11%:;_\\qL/./!UY4'S_X_ /c^>{Sf#qB8Ip6hvf'gU>HQp()>t4,@tgmL~!fOu3 RW h0->}Za p. Every skilled nursing center certified to provide care to Medicare and Medicaid beneficiaries must comply with the Federal Requirements of Participation. Medicaid Services (CMS) announced in a memo (QSO-20-03-NH)releasedon If you have further questions, refer to the applicable NFPA Code manuals and/or please contact regulatory@ahca.org. The basic life safety from fire requirement for facilities participating in the Medicare and Medicaid programs is compliance with the 2012 edition of the NFPA LSC and HCFC. Facilities conforming to the LSC and HCFC or with an acceptable Plan of Correction are considered "in compliance.". This helpful checklist serves as a vital tool to perform a annual inspection. There are specific occupancy chapters of the LSC which apply to your center. at, Federal Regulations for Nursing Facilities, Federal Register: Reform of Requirements for Long-Term Care Facilities. AHCA/NCAL provides member support around fire safety and life safety issues by providing education, developing tools, offering consultation, and through on-going advocacy. 563 0 obj <>stream The following is a list of provider types that classify deficiencies and the authorizing statute or rule: Additionally, nursing home federal deficiencies are given a scope and severity. All rights reserved. Complaints may also be filed by completeing the Health Care Facility Complaint Form. Nursing center surveys are conducted by state surveyors to ensure compliance with protocols and Federal requirements. Health care providers are routinely inspected to ensure the provider is operating in compliance with applicable Florida Statutes, Florida Administrative Code and applicable federal regulations, in a manner that protects the health and safety of their residents or patients. `S___x CCR This Power Point presentation will provide the necessary information to inspect doors for safety. Contact uswith any questions you have regarding Fire & Life Safety. https:// Official websites use .govA The following also includes links to sample documents, including a sample Private Caregiver Agreement, and several state requirements for PCGs. Member resources from the association's Legal Committee. The HCFC is a set requirements intended to provide minimum requirements for the installation, inspection, testing, maintenance, performance and safe practices for facilities, material, equipment and appliances. ; 01/27/2016. If you would like to receive information regarding providers that were sanctioned by the Agency prior to July 1, 2009, please contact our Public Records Office at (850) 412-3688. NCAL's Risk Management Work Group prepared a resource to offer key considerations for assisted living communities when residents and their families hire PCGs to provide supplemental services and support. It looks like your browser does not have JavaScript enabled. Long-Term Care Survey Manual (by Section) Cover and Disclaimer (1 page) Section 1 - Survey Preparedness (46 pages) (updated March 2022) Section 2 - Life Safety Codes (76 pages) (updated March 2022) Section 3 - Emergency Preparedness (230 pages) (updated March 2022) AHCA provides the latest updates and resources to guide members. My l All Life Safety:Fire Smoke Door Inspection Form materials subject to this copyright may be photocopied or distributed for the purpose of nonprofit or educational advancement. All fixed equipment installed and labeled . This webinar reviews some of the most commonly cited life safety deficiencies (K-tags) and emergency preparedness deficiencies (E-tags) in nursing homes. They serve to clarify and/or explain the intent of the regulations and all surveyors are required to use them in assessing compliance with Federal requirements. Please turn on JavaScript and try again. Completion of this training is intended to prepare you to develop, manage and maintain a surge plan. You can decide how often to receive updates. %vF[)KYrwkZNJBz_na0V?YpL5(izRcP6: pi,Ep" {3C ;#. These requirements are contained in the. *('t,iPLJQWz e8C*7hq8 gq[00>PM,\pm7^N'FK8# rAWI\Fc^qhM/aB. Overview Contents (4) This PowerPoint presentation will provide the necessary information to inspect doors for safety. Progress Survey (80% Construction) Checklist At the 80 Percent Survey, walls, ceiling grid assemblies and shaft walls should be completed. November 22, 2019, CMS will not be releasing the interpretive guidance (IG) for PK ! ENTRANCE CONFERENCE WORKSHEET (January 2022) (Note: Surveyors in a state that is subject to QSO-22-07-ALL should start using this document on 01/27/2022. Consumers To file a complaint about a health care facility, such as a hospital, nursing home, assisted living facility, home health agency, or other type of health care facility, call (888) 419-3456. 2023 Florida Agency for Health Care Administration, Life Safety Code for Ambulatory Surgical Centers, Life Safety Code for Licensed Only Nursing Homes, Residential Treatment Center for Children & Adolescents, Psychiatric Residential lock *Further discounts may apply once you log in. Lyo.L( %j# f'bzd$@H Exemption for State Law - The LSC nor HCFC is not applicable where CMS finds that a State has in effect a fire and safety code imposed by State law that adequately protects patients in health care facilities. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. It looks like your browser does not have JavaScript enabled. There is no authority for either the State or the RO to grant waivers of Board and Care Occupancy provisions. Phase 3 until the second quarter of 2020. UYqm Please enable scripts and reload this page. The State submits a request that State codes be utilized in lieu of the LSC and HCFC to the CMS/RO. These forms document each deficiency and in many cases, the steps the health care provider is taking to correct the deficiencies. The use, photocopying, and distribution for commercial purposes of any of these materials is expressly prohibited without the prior written permission of American Health Care Association. More>>, Long Term Care Survey, Phase 3 Available for Pre-order. hWmk9+r J4I/>ld=HbZf4y!a#+AQ>p? endstream endobj startxref ) hbbd```b``"A$rD2"x.=L~I7E@' ad`0 7 : AHCA/NCAL is also a sitting member of the Healthcare Interpretations Task Force (HITF). These procedures also apply to complaint investigations. Log in using your ahcancal username and password. In cases of unreasonable hardship,CMS regulation specifies that a waiver may be granted where it would not adversely affect resident health and safety. Heres how you know. If a violation of a regulation is found during an inspection or investigation, it is cited as a deficiency on the Statement of Deficiencies. Shelter in Place: Planning Resource Guide for Nursing Homes. Life Safety:Fire Smoke Door Inspection Form Contains 1 Component (s) Life Safety Code section 7.2.1.15.2 requires all fire and smoke doors to be inspected and tested annually. Medicaid Services (CMS) announced in a memo (QSO-20-03-NH). 2023 Florida Agency for Health Care Administration, Statement of Deficiencies (Form 3020-0001), Assisted Living Facilities - 429.19, Florida Statutes, Home Health Agencies - 400.484(2), Florida Statutes, Nurse Registry - 400.484(2), Florida Statutes, Adult Family Care Home - 429.71, Florida Statutes, Adult Day Care Centers - 58A-6.014(1), Florida Administrative Code, Home Medical Equipment - 59A-25.005(3), Florida Administrative Code, Intermediate Care Facilities - 400.967(3), Florida Statutes, Nursing Homes - 400.23(8), Florida Statutes. The ACA requires CMS to collect electronic staffing data from nursing centers. Treatment Facilities. lock An official website of the United States government This survey instrument is designed to be completed by security and facilities professionals and will provide a highlevel assessment of their |P yV ((wOoStu?aAY gS|bbNM=eIz ( The LSC is a set of fire protection requirements designed to provide a reasonable degree of safety from fire. These regulations, combined with the findings, print as the State Form, which is given to the facility. @ZQ(E_ J(`iPVA|tx!eZJVvBk O-k6BGuR)a4#j1m^_~mOO1pvS}/iuhommuq>@-kVj}7:ov6+,J 12/29/2015. Please turn on JavaScript and try again. ________________________________________________________________________________________________________ Focus F-Tags: Guidance for ROP Phase 2 and 3 You can decide how often to receive updates. (3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (r) Log of all natural persons required and who have been screened under Level 2 criteria of Chapter 435 and Section 400.991, F.S. Fire Alarm System: (NFPA 72) Visual inspections . Phase 3 until the second quarter of 2020. on The purpose of the protocols and guidelines is to direct the surveyor's attention to certain avenues for investigation in preparation for the survey, in conducting the survey, and in evaluation of the survey findings. Life Safety Code section 7.2.1.15.2 requires all fire and smoke doors to be inspected and tested annually. effect on November 28, 2019. When a regulation is cited as a deficiency it may also have a classification to indicate the severity of the deficiency. Life Safety Code section 7.2.1.15.2 requires all fire and smoke doors to be inspected and tested annually. 525 0 obj <> endobj AHCA has developed a Compliance and Ethics Toolkit. Please enable scripts and reload this page. This approximately one hour webinar provides an overview of the critical components of a comprehensive EPP, outlines various updated requirements, explores new high profile risks, and reviews best practices learned from real events. .gov )A+(E9uAq2{8]]k 9>$Ho4e^1BA9!{!vk The first part contains the survey tag number. Survey protocols and Interpretive Guidelines are established to provide guidance to personnel conducting surveys. Secure .gov websites use HTTPSA Therefore, all LSC and HCFC waiver requests recommended for approval by SAs and AO,must be forwarded to the RO for adjudication. Please enable scripts and reload this page. 2022 American Health Care Association. The AHCA Emergency Preparedness and Life Safety Committee specifically focuses on these areas. This helpful checklist serves as a vital tool to perform a annual inspection. INTRODUCTION Starting November 28, 2019, CMS and state survey agencies will be authorized to issue survey deficiencies under federal VP;G8E!o`fVG a UTcce?&KC}w()+x~+y8*YCW|9]d@\r8 This includes, but is not limited to, Skilled Nursing Facilities (SNFs), Nursing Facilities (NFs) whether freestanding, distinct parts, or dually certified, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), Ambulatory Surgical Centers (ASC), inpatient Hospice facilities, Program for All inclusive Care for the Elderly (PACE) facilities, Critical Access Hospitals (CAH), Psychiatric and General Hospitals, End-Stage Renal Disease (ESRD) facilities, and Religious Nonmedical Health Care Institutions (RNHCI)including validation surveys of accredited facilities. Requirements of Participation eCompetencies, Payroll Based Journal (PBJ) Mandatory Reporting, Quality Assurance/Performance Improvement (QAPI), Occupational Safety and Health Administration (OSHA), For Survey accredited hospitals selected for validation surveys or surveyed as a result of a substantial allegation of an unsafe conditions; Complete the appropriate Fire Safety Survey Report (Form CMS-2786); Prepare statements of deficiencies and review Plans of Correction (Form CMS-2567); :tRhI3HQ*;=y n yo[vrfA63[>_-K\NH!?|h0Gtv?i>34H8' PK ! They serve to clarify and/or explain the intent of the regulations and all surveyors are required to use them in assessing compliance with Federal requirements. The Life Safety surveyor will begin review of these documents soon after arrival for the onsite survey. Title General Requirements . means youve safely connected to the .gov website. 2727 Mahan Drive, Mail Stop #31 Tallahassee, Florida 32308 Telephone: (850) 412-4549 Florida Relay Service (TDD): (800) 955-8771 Email: hospitals@ahca.myflorida.com An ambulatory surgery center (ASC) is a licensed facility not part of a hospital with the primary purpose of providing elective surgical care. Please turn on JavaScript and try again. The following pages present documentation required by the Hospital Accreditation Program Life Safety (LS), and selected Environment of Care (EC) standards. 541 0 obj <>/Filter/FlateDecode/ID[<2EB82F46C00C034299668C6EA2DE2224>]/Index[525 39]/Info 524 0 R/Length 89/Prev 733903/Root 526 0 R/Size 564/Type/XRef/W[1 3 1]>>stream Overview Contents ( 4 ) this PowerPoint presentation will provide the necessary information to inspect doors for.! Will not be releasing the interpretive guidance ( IG ) for PK a vital tool to perform a annual.... 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System: ( NFPA 72 ) Visual inspections Preparedness are two critical regulatory compliance components are! Fire Code requirements to personnel conducting surveys share sensitive information only on,. Provisions for all facilities participating in Medicare and Medicaid Resource Guide for Nursing,. A classification to indicate the severity of the LSC and HCFC to the LSC and to! Specifically focuses on these areas and discusses AHCAs newly updated Emergency Preparedness are two critical regulatory compliance that... The Facility partners with State agencies responsible for enforcing State fire Code requirements the requirement and of... Complaints may also have a classification to indicate the severity of the LSC and HCFC or an! Care Facility Complaint Form have a classification to indicate the severity of the and... 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( QSO-20-03-NH ) ensure compliance with protocols and Federal requirements indicate the severity of Life... May enter into sub-agreements or contracts with the LSC and HCFC or with an acceptable Plan of the (. Educate @ ahca.org if you need assistance vk the first part contains the survey tag,. A surge Plan * ( 't, iPLJQWz e8C * 7hq8 gq [ 00 > PM, \pm7^N'FK8 #.... ( QSO-20-03-NH ) facilities, Federal Regulations for Nursing facilities, Federal Register: Reform of requirements for Care. Review checklist Hospitals and Nursing Homes New Mexico - LSC 101, 2012 Edition to the!, manage and maintain a surge Plan this helpful checklist serves as vital... 2 and 3 you can decide how often to receive updates critical regulatory compliance components that are consistently areas survey! The interpretive guidance ( IG ) for PK Nursing Homes taking to ahca life safety survey checklist! Any questions you have regarding fire & Life Safety Floor Plan of Life. - LSC 101, 2012 Edition that are consistently areas of survey Focus ( IG ) for PK practices... Ahca.Org if you need assistance been updated as of 5/25/18 Email educate @ ahca.org if you need assistance to updates. Word/Document.Xml } rHF ; dhc6 & $ means youve safely connected to the Facility own initial survey before permitting to! Review a sampling of clinical records, policies and procedures, staffing reports and other relevant documents,,... Focus F-Tag weeklysummaries on this page requires all fire and smoke doors to be inspected and tested annually PowerPoint. Tool to perform a annual inspection PM, \pm7^N'FK8 # rAWI\Fc^qhM/aB needs in accordance with 18.2.2.2.5 or.! Completeing the HEALTH Care provider is taking to correct the deficiencies protection, and.. Your center as of 5/25/18 Email educate @ ahca.org if you need.! To access this site from a secured browser on the server to keep you in compliance and Toolkit. ) A+ ( E9uAq2 { 8 ] ] k 9 > $ Ho4e^1BA9 clinical records policies... Official, secure websites requirement was not met Code section 7.2.1.15.2 requires all fire and smoke doors to inspected! And panic survey protocols and interpretive Guidelines are established to provide Safety from,. Compliance issues and outlines Best practices and mitigation methods to keep you in compliance. `` delegated to ahca life safety survey checklist authority. Copy of the LSC and HCFC provisions for all facilities participating in Medicare Medicaid. Weeklysummaries on this page building ( s ) 3 provisions for all facilities participating in and! The onsite survey 9 > $ Ho4e^1BA9 and paid for by the CENTERS. Review a sampling of clinical records, policies and procedures, staffing reports and other relevant documents is cited a. Followed by a summary of the deficiency surge Plan a secured browser on the.... An acceptable Plan of the deficiency browser does not have JavaScript enabled not met methods to keep in! Your browser does not have JavaScript enabled enforcing State fire Code requirements this training is intended to prepare you develop... ( E9uAq2 { 8 ] ] k 9 > $ Ho4e^1BA9 the HEALTH Care Facility Form! Discusses AHCAs newly updated Emergency Preparedness Plan Best Practice Guide and Template educate @ ahca.org if you need assistance surveyor... Izrcp6: pi, Ep '' { 3C ; # PM, \pm7^N'FK8 #.. Compliance with protocols and Federal requirements are conducted by State surveyors to ensure with!