The Center for Medicare & Medicaid Services (CMS) released new Interpretive Guidance for several quality of life and environment tags on April 10. These changes grew from the "Creating Home" national symposium cosponsored by CMS and the Pioneer Network in April 2008. A rundown of the most recent CMS Interpretive Guidance changes is presented. F172 Access and Visitation Rights states that visitors must have 24-hour access to residents with reasonable restrictions defined as anyone who might affect the security of all residents. F252 Safe, clean, comfortable, and homelike environment de-emphasizes the institutional character of the setting. CMS now lists some good practices to decrease institutional character. F256 Adequate, comfortable lighting levels in all areas gives better guidance regarding adequate lighting feature. F461 Environment requires several things and has always included individual closet space in the resident's bedroom with clothes racks and shelves accessible to the resident.