US · guidance
CMS SOM App. U, Tag R220
(3) CMS may permit variances in requirements specified in paragraphs (b)(1)(i) and
(ii) of this section relating to rooms on an individual basis when the RNHCI
adequately demonstrates in writing that the variances meet the following:
(i) Are in accordance with the special needs of the patients.
(ii) Will not adversely affect patients’ health and safety.
Interpretive Guidelines: §403.742(b)(3)
A variance must be in accordance with the special needs of the patients and must not
adversely affect the health or safety of patients. Facility hardship is not part of the basis
for granting a variance. Since the special needs of patients may change periodically, or
different patients may be transferred into a room that has been granted a variation,
variations must be reviewed and considered for renewal whenever the facility is certified.
If the needs of the patients within the room have not changed since the last inspection, the
variance should continue if the facility so desires.
Survey Procedures:
• The variances must be reviewed and considered for renewal whenever the facility
is certified.
History
Rev. 239; Issued: 04-24-26; Effective: 04-24-26; Implementation: 04-24-26
Provenance
- Source
- cms.gov
- Retrieved
- 2026-07-22
- Edition
- som-2026-07-22
- Content hash
562546fca7afee36159d87891f44eb6636863ed2026aa6d381ecdfd20b063bc3
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