Healthcare reform, News, Skilled Nursing Facility

CMS proposes major revision to regulations for long-term care

On July 13, 2015, the Centers for Medicare & Medicaid Services (CMS) announced a proposal to improve the quality of care and safety affecting long-term care residents. Regulations regarding reduction of unnecessary hospital readmissions and infections, increased quality of resident care, and strengthened safety measures top the major revisions in CMS’ proposed rule CMS-3260-P, which is expected to be released in the July 16, 2015, Federal Register.

If finalized, this proposed rule would mark the first major rewrite of the long-term care Conditions of Participation since 1991. According to the CMS press release, the rule would bring best practices for resident care to all facilities that participate in Medicare or Medicaid; it would also implement a number of important safeguards that have been identified by patient advocates and other stakeholders, and include additional protections required by the Affordable Care Act.

Changes include:

  • Making sure that nursing home staff are properly trained on caring for residents with dementia and preventing elder abuse.
  • Ensuring that nursing homes consider the health and proper care of residents when making staffing decisions.
  • Ensuring that staff members have the right skill sets and competencies to provide person-centered care to residents. The care plan developed will take the resident’s goals of care and preferences into consideration.
  • 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, 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.
  • Requiring nursing homes to provide greater food choice for residents while also giving nursing homes flexibility.
  • Updating nursing homes’ infection prevention and control programs, including requiring an infection prevention and control officer, as well as an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use.
  • Strengthening rights of nursing home residents, including placing limits on when and how binding arbitration agreements may be used.

There will be a 60-day comment period on the proposed revisions contained in CMS-3260-P. To submit a comment, click here.