CMS Issues Final Rule Reforming Requirements for Long-Term Care Facilities

PUBLISHED: Oct 6, 2016

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule making major changes to improve the care and safety of the nearly 1.5 million residents in the more than 15,000 long-term care facilities that participate in the Medicare and Medicaid programs. The policies in this final rule are targeted at reducing unnecessary hospital readmissions and infections, improving the quality of care, and strengthening safety measures for residents in these facilities.

The final rule is effective November 28, 2016 and will be subject to a phased implementation:

  • Phase I effective November 28, 2016
  • Phase II effective November 28, 2017
  • Phase II effective November 28, 2019

Changes finalized in this rule include:

  • Strengthening the rights of long-term care facility residents, including prohibiting the use of pre-dispute binding arbitration agreements.
  • Ensuring that long-term care facility staff members are properly trained on caring for residents with dementia and in preventing elder abuse.
  • Ensuring that long-term care facilities take into consideration the health of residents when making decisions on the kinds and levels of staffing a facility needs to properly take care of its residents.
  • Ensuring that staff members have the right skill sets and competencies to provide person-centered care to residents. The care plans developed for residents will take into consideration their goals of care and preferences.
  • Improving care planning, including discharge planning for all residents with involvement of the facility’s interdisciplinary team and consideration of the caregiver’s capacity, giving residents information they need for follow-up after discharge, and ensuring that instructions are transmitted to any receiving facilities or services.
  • Allowing dietitians and therapy providers the authority to write orders in their areas of expertise when a physician delegates the responsibility and state licensing laws allow.
  • Updating the long-term care facility’s infection prevention and control program, including requiring an infection prevention and control officer and an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use.

The final rule is available on the Federal Register and at the link below. StayAlert! is reviewing the final rule in detail and will be publishing additional notices with updated example policies in upcoming weeks.

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