Exception

6138.3 - Exception (Rev. 230; Issued: 07-11-25; Effective: 07-11-25; Implementation: 07-11-25) Form CMS-209 is completed at the time of the survey. This form is currently not available in electronic form in the CLIA Data System. The SA either retains a hard copy or scans a copy of the Form CMS-209 (Exhibit 106) until updated or revised at the next survey to prevent evaluation of the same personnel on two consecutive surveys as part of the survey sample of personnel.