CMS Proposed Rule Addresses Long Term Care Regulatory Provisions

PUBLISHED: Jul 17, 2019
Relevant to: Long Term Care

The Centers for Medicare (CMS) has issued a proposed rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P) that will remove requirements for participation identified as unnecessary, obsolete, or excessively burdensome on long-term care (LTC) facilities. The rule is part of the agency’s five-part approach to ensuring a high-quality LTC facility system that focuses on strengthening requirements for such facilities, working with states to enforce statutory and regulatory requirements, increasing transparency of facility performance, and promoting improved health outcomes for facility residents. CMS expects the provisions in the rule, if finalized, to achieve $616 million in savings annually for these facilities.

Highlights of the proposed rule:

  • Reduces the frequency that LTC facilities are required to conduct a facility assessment.
  • Allows LTC facilities the flexibility to streamline their compliance and ethics programs.
  • Reduces the requirements for individuals responsible for the compliance and ethics program and reduces the frequency for the program’s review.
  • Increase flexibility by providing that those who have performed as the director of food and nutrition services for a minimum of two years by allowing them to continue doing so without obtaining additional certification.
  • Requires newly hired directors of food and nutrition services or those with less than two years of experience to complete, at a minimum, a course in food safety and management.
  • Allow facilities greater flexibility in tailoring their Quality Assurance Program Improvement (QAPI) program to the specific needs of their individual facility by eliminating prescriptive requirements.
  • Updates Informal Dispute Resolution (and independent process) by adding timeframes on process, and increased provider transparency.

In order to give facilities enough time to respond to these proposed changes, CMS is also proposing to delay the implementation of certain phase 3 QAPI and compliance and ethics related requirements finalized in October 2016. The new effective date for phase three of the QAPI requirements would be one year following the effective date of the newly proposed rule.

CMS is currently seeking feedback on the proposed rule. Comments will be accepted through September 16, 2019.

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