On July 16, 2015, the Federal Register published Centers for Medicare and Medicaid Services' (CMS) proposed rule to reform the requirements for Long Term Care Facilities participating in Medicare and Medicaid. CMS will be accepting comments to the proposed rules for 60-days. The 400-page proposed rule recommends the biggest overhaul to nursing home requirements since 1991.
This is the fourth and final alert in a series of communications regarding the proposed rule reform for Long Term Care Facilities. Long term care providers and other interested entities should carefully review the proposed rule and submit any comments to the proposed rule to CMS/HHS by 5:00 pm EST on September 14, 2015.
To see a copy of the proposed rule, click here.
Summary of Proposed Changes to Clinical Requirements for Long Term Care Facilities
The proposed rule introduces a number of revisions and new sections relating to residents' rights in Long Term Care Facilities. The following is a brief overview of the changes to the residents' rights CMS proposes: [Click here for our expanded overview.]
• TCMS has proposed to expand the prohibition on employing or engaging individuals who have been found guilty of abuse, neglect or maltreatment to also prohibiting facilities from employing or engaging individuals who have had their professional license disciplined by a state licensing board based on a finding of abuse, neglect, mistreatment or misappropriation of property.
• The rule retains all existing residents' rights but updates the language of those rules and updates the organization of the residents' rights provisions. The changes are designed to improve the logical order and readability of the regulations.
• The language updates are designed to clarify certain aspects of the regulations to comply with current practices.
• CMS is proposing to add new requirements to the care planning process and require facilities to incorporate each resident's personal and cultural preferences in developing goals of care.
• The proposed rule also recommends changing certain requirements related to protecting residents' funds and providing more consistent guidance in the threshold amounts that need to be placed in interest-bearing accounts for residents.
• Similarly, the proposed rules attempt to expand the treatments that residents can participate in beyond self-administration of drugs.
• CMS is proposing a regulation to create a more "open" visitation policy in Skilled Nursing Facilities.
• The proposed rules seek to expand the nature and types of communications that a facility must provide residents in a "form and manner" that the resident can access and understand.
• In addition to the existing regulations requiring facility's to post their local and state complaint hotlines, CMS is also proposing that facility's be required to post contact information for local advocacy groups, state licensure offices, and their Ombudsmen.
• CMS is proposing a new rule that will establish a resident's right to communicate with individuals inside and external to the facility, including ensuring reasonable access to the internet, TTY and TTD services, stationary, postage, writing implements, and the ability to send mail.
• In an attempt to expand a resident's right to voice grievances, CMS is proposing new regulations to ensure residents know how to file grievances by requiring the creation, implementation and distribution of a grievance policy.
• The proposed rule also seeks to add language regarding physician credentialing to specify that the physician chosen by the resident must be licensed to practice medicine in the state where the resident resides, and must meet professional credentialing requirements of the facility. Importantly, industry and trade groups have expressed concern that this credentialing requirement has the potential to impose significant costs and burdens on facilities.
To view the full alert, or to download the PDF, click here.
Upcoming Information for You
This is the fourth and final alert in a series of four communications regarding the proposed rule reform for long term care facilities. Additional alerts outlining other proposed revisions are listed at left.
What You Should Do
Long term care providers and other interested entities should review the e-alerts, carefully review the proposed rule and submit any comments to the proposed rule to CMS/HHS by 5:00 pm EST on September 14, 2015. Comments may be submitted electronically here or by regular mail to CMS/HHS, Attn: CMS-3620-P, P.O. Box 8010, Baltimore, MD 21244.
To download the full alert, click here.
For More Information
If you have questions regarding the proposed rule or how it may affect your long term care facility, please contact:
- Matt J. Murer | 312.873.3603 | Email
- Meredith A. Duncan | 312.873.3602 | Email
- Jason T. Lundy | 312.873.3604 | Email
- Charles P. Sheets | 312.873.3605 | Email
- Mary Beth Blake | 816.360.4284 | Email
- Dayna C. LaPlante | 312.463.6348 | Email
- Hannah L. Neshek | 312.873.3671 | Email