CMS · Survey deficiency reference

A-0722 Standard: Facilities (§482.41(d)), with A-0724

Identifier and Official Title

A-0722 is the tag for 42 CFR §482.41(d). The heading as printed in Appendix A Rev. 238 reads, verbatim:

A-0722 (Rev. 238; Issued: 03-20-26; Effective: 09-05-25; Implantation: 09-05-25) §482.41(d) Standard: Facilities

Its sub-tags are A-0723 (§482.41(d)(1), “Diagnostic and therapeutic facilities must be located for the safety of patients.”) and A-0724 (§482.41(d)(2), quoted below). Verified against the full text of Rev. 238 on September 11, 2026.

What It Enforces (Verbatim)

The standard, as printed under A-0722 and identical to 42 CFR §482.41(d) in eCFR:

(d) Standard: Facilities. The hospital must maintain adequate facilities for its services.

The paragraph tagged A-0724:

(2) Facilities, supplies, and equipment must be maintained to ensure an acceptable level of safety and quality.

The regulation contains no pest language; “pest,” “vermin,” “rodent,” “insect,” and “infestation” do not appear anywhere in Part 482 or in Appendix A Rev. 238 (0 occurrences, measured). In survey practice §482.41(d) is where pest activity in food preparation areas and other service spaces is framed as a failure to maintain adequate, safe facilities for the service being delivered rather than as a general physical-plant failure under A-0701. The framing is the surveyor’s.

A-0722 Interpretive Guidelines and Survey Procedures (Verbatim, Complete)

Interpretive Guidelines §482.41(d)

Adequate facilities means the hospital has facilities that are:

• Designed and maintained in accordance with Federal, State and local laws, regulations and guidelines; and

• Designed and maintained to reflect the scope and complexity of the services it offers in accordance with accepted standards of practice.

Survey Procedures §482.41(d)

• Observe the facility layout and determine if the patient’s needs are met. Toilets, sinks, specialized equipment, etc. should be accessible.

• Review the facility’s water supply and distribution system to ensure that the water quality is acceptable for its intended use (drinking water, irrigation water, lab water, etc.). Review the facility water quality monitoring and, as appropriate, treatment system.

“Designed and maintained in accordance with Federal, State and local laws, regulations and guidelines” is the sentence that pulls the state-adopted FDA Food Code and its pest control section into a hospital kitchen finding.

A-0724 Interpretive Guidelines (Verbatim, the Facilities and Supplies Passages)

Interpretive Guidelines §482.41(d)(2)

Facilities

The hospital must ensure that the condition of the physical plant and overall hospital environment is developed and maintained in a manner that provides an acceptable level of safety and well-being of patients, staff and visitors.

Supplies

The hospital must ensure that supplies are maintained to provide an acceptable level of safety and quality for patients. […]

Supplies must be stored in such a manner to ensure their safety (e.g., protection against theft or damage, contamination, or deterioration), as well as that the storage practices do not violate fire codes or otherwise endanger patients (e.g., storage of flammables, blocking passageways, storage of contaminated or dangerous materials, safe storage practices for poisons, etc.).

The rest of the A-0724 guidance concerns equipment maintenance and Alternate Equipment Management programs and is not pest-relevant. The “condition of the physical plant … safety and well-being” sentence (which also appears, in slightly different form, under A-0701) is the closest hospital-side hook for a pest finding under the Physical Environment condition; the supplies passage is where pest-contaminated stock in a storeroom is written.

What the Surveyor Is Looking For

In dietary and food service the surveyor’s observation is usually specific: droppings in dry storage, cockroach evidence at floor-wall junctions or behind equipment, flies at a receiving door, gnaw marks on packaging. The surveyor then looks for the four things the FDA Food Code requires of any food establishment, because the state food inspector will look for the same four: routine inspection of incoming shipments, routine inspection of the premises, documented methods when pests are found, and elimination of harborage conditions.

The hospital’s own kitchen inspection logs, the pest vendor’s service records for the kitchen, and the dietary manager’s account of what happened after the last observation are the evidence the surveyor weighs. Note that hospital dietary services also carry their own condition, §482.28, whose Appendix A guidance (tag A-0618) expects written policies covering “Guidelines for kitchen sanitation” and “Integration of the food and dietetic service into the hospital-wide QAPI and Infection Control programs”; a kitchen pest finding may be written there as well.

Documentation That Satisfies It

• Receiving inspection records for food and supply deliveries
• Kitchen self-inspection logs with pest evidence as a line item
• Pest vendor service records for dietary showing inspection, sanitation, exclusion, and mechanical controls as well as any chemical application, with products selected for food-service use
• Work orders closing harborage and entry conditions (floor drains, wall penetrations, door seals, equipment gaps)
• Supply-storage inspection records showing stock protected against contamination, which is what the A-0724 guidance asks for
• The HACCP prerequisite program documentation, where the kitchen runs HACCP
• Coordination records between dietary, environmental services, and the pest vendor

Where Facilities Most Commonly Fail

• Pest control in dietary is documented as a service contract but not as a program: no thresholds, no receiving inspection, no harborage work
• The dietary staff observe activity but there is no route from the kitchen to the pest vendor, so nothing happens until the next scheduled visit
• The kitchen’s HACCP binder lists pest control as a prerequisite program but the supporting records are years old
• Structural harborage (drains, junctions, equipment gaps) is treated as the vendor’s problem instead of a facilities work order

Plan of Correction: What It Must Address

Appendix A’s own survey protocol (Rev. 238, exit-conference instructions) tells surveyors to:

Inform the facility that a written plan of correction must be submitted to the survey agency within 10 calendar days following receipt of the written statement of deficiencies.

and to explain the required characteristics of a plan of correction, which the protocol lists verbatim as:

Corrective action to be taken for each individual affected by the deficient practice, including any system changes that must be made;

• The position of the person who will monitor the corrective action and the frequency of monitoring;

• Dates each corrective action will be completed;

• The administrator or appropriate individual must sign and date the Form CMS-2567 before returning it to the survey agency; and

• The submitted plan of correction must meet the approval of the State agency, or in some cases the CMS Regional Office for it to be acceptable.

The protocol’s post-survey section adds that 42 CFR 488.28(a) allows certification with deficiencies “only if the facility has submitted an acceptable plan of Correction [POC] for achieving compliance within a reasonable period of time acceptable to the Secretary,” and that “After a POC is submitted, the surveying entity makes the determination of the appropriateness of the POC.”

For a kitchen or storeroom pest finding the plan has to show: remediation of the observed activity and the harborage that produced it, with the service records; inspection of the other food and supply areas; the system change (receiving inspection, thresholds, a route from dietary to the vendor, harborage work orders, disposal of contaminated stock); the position that monitors it and how often; and a completion date for each action. The structure is not a template, and the surveying entity decides whether the plan is acceptable.

Confidence Notes

HIGH confidence. The tag headings, regulation text, Interpretive Guidelines, and Survey Procedures are transcribed from Appendix A Rev. 238 (Issued 03-20-26), read in full from the reference’s archived copy of the CMS PDF on September 11, 2026. The regulation text was matched against the eCFR XML of 42 CFR Part 482. The Food Code and HACCP framing is carried from those authority pages. The description of survey practice is the reference’s characterization, not CMS text.