Crosswalk

Revisions to CMS-3070G

Intermediate Care Facilities For Individuals With Intellectual Disabilities Survey Report
Page
#

1

Section

Action to be performed

Question 15 Change title of subSurvey
sections H, I & J
Team
Composition

Changes to the Application

Change the title of the following
subsections:

Subsection H:
from “Laboratorian” to “Medical
Laboratory Technologist”
Subsection I:
from “Sanitarian” to “Public Health
Specialist”
Subsection K:
from “Therapist” to “Physical
Therapist”

2

Question 20

2

Question
20(b)(2)

(renumbered
as question
19(b)(2) in
revised CMS3070G form

Re-number question #20
to #19

Re-number question #20 to #19

Change the term
“Autism” to “Autism
Spectrum Disorder”

Change “Autism” to “Autism
Spectrum Disorder”

Reasons for the Change

The terms used in subsections H and I
of the current version of the CMS3070G are outdated and not used
today. We have updated them in the
revised version of the CMS-3070G
form to the contemporary terms used
today.
The term used in subsection K of the
current CMS-3070G form is vague
because it does not specify the type of
therapist. We have revised this term
in the revised version of the CMS3070G form to “physical therapist”
because it is more specific.

Question #20 is mis-numbered in the
current version of the CMS-3070G
form. It should be labeled as question
#19 because the previous question is
#18.
We have changed the term “Autism”
to “Autism Spectrum Disorder”
because this is the currently accepted
and used term for this disorder.

Page
#

2

2

2

Section

Action to be performed

Changes to the Application

Question
20(b)(4)

Change the term
“Epilepsy” to “Seizure
Disorder”

Change the term “Epilepsy” to
“Seizure Disorder”

Question
20(c)(1)

•

•

Change the term “Non-Mobile” to
“Ambulatory Status”

•

Change the tern “Mobile” to
“Ambulatory”

•

Change the term “Non-Mobile” to
“Non-Ambulatory”

(renumbere
d as
question
19(b)(4) in
revised
CMS-3070G
form
(renumbere
d as
question
19(c)(1) in
revised
CMS-3070G
form
Question
20(c)(3)

(renumbere
d as
question
19(c)(3) in
revised
CMS-3070G
form

•

•

Change the term
“Non-Mobile” to
“Ambulatory Status”
Change the tern
“Mobile” to
“Ambulatory”
Change the term
“Non-Mobile” to
“Non-Ambulatory”

Change the term “Hard of Change the term “Hard of Hearing” to
Hearing” to “Partial
“Partial Hearing Loss”
Hearing Loss”

Reasons for the Change

We have changed the term “Epilepsy”
to “Seizure Disorder” because this is
the currently used term for this
disorder.

These terms in the current version of
the CMS-3070G form are outdated.

The new terms are currently used and
accepted for these activities.

We have changed the term “Hard of
Hearing” because it is outdated and is
not a medically accepted term.
The term “Partial hearing loss” is a
medically accepted term that is
currently used today and is more
descriptive of the type of hearing loss
being described.

Page
#

2

2

2

Section

Question
20(c)(4)

(renumbere
d as
question
19(c)(4) in
revised
CMS-3070G
form

Action to be performed

Change the term
“Impaired” to “Visually
impaired”

Changes to the Application

Change the term “Impaired” to
“Visually impaired”

Question
20(E)

Change the term “Drugs
to control behavior” to
“Use of drugs to control
behavior”

Change the term “Drugs to control
behavior” to “Use of drugs to control
behavior”

Question
20(F)

Change the term
“Physical restraints” to
“Use of physical
restraints”

Change the term “Physical restraints”
to “Use of physical restraints”

(renumbere
d as
question
19(E) in
revised
CMS-3070G
form
(renumbere
d as
question
19(F) in
revised
CMS-3070G
form

Reasons for the Change

We have changed the term
“Impaired” to “Visually impaired”
because it does not properly
characterize the type visual loss being
described.

The term “Visually impaired” is more
descriptive of the type of hearing loss
and is the currently used medical
term.
We have added the words “Use of” to
beginning of this requirement to
make it more descriptive of the type
of information being collected.

We have added the words “Use of” to
beginning of this requirement to
make it more descriptive of the type
of information being collected.

Page
#

2

Section

Question
20(G)

(renumbere
d as
question
19(G) in
revised
CMS-3070G
form

Action to be performed

Change the term “Timeout rooms” to “Use of
time-out rooms”

Changes to the Application

Reasons for the Change

Change the term “Time-out rooms” to
“Use of time-out rooms”

We have added the words “Use of” to
beginning of this requirement to
make it more descriptive of the type
of information being collected.