Proposed Revisions to the Federal Nursing Home Regulations Now Published- Comments due by September 14, 2015

August 24, 2015

The Centers for Medicare & Medicaid Services (CMS) published proposed revisions for the federal requirements that nursing homes must meet in order to participate in the Medicare and Medicaid programs (also known as Requirements of Participation). The full text of the proposed rule is available on the Federal Register website and individuals, groups, and organizations may submit formal comments regarding the proposed revisions through the Federal Register website until September 14, 2015.

According to the preamble these revisions were proposed “to reflect the substantial advances that have been made over the past several years in the theory and practice of service delivery and safety. These proposals are also an integral part of [CMS’] efforts to achieve broad-based improvements both in the quality of health care furnished through federal programs, and in patient safety, while at the same time reducing procedural burdens on providers.”

The proposed rule is reorganized and includes modified and new definitions, provisions, and sections, such as the Quality Assurance and Performance Improvement (QAPI) section (483.75), provisions regarding binding arbitration agreements, Transitions of Care section (formerly known as “Admission, transfer, and discharge rights”), and a requirement for reporting suspicion of a crime (CMS Survey & Certification Memo regarding this requirement). The new QAPI section was added in accordance with the Affordable Care Act requirement for the Secretary to “establish and implement a Quality Assurance and Performance Improvement (QAPI) program requirements” and the proposed section requires facilities to “develop, implement, and maintain an effective comprehensive, data-driven QAPI program that focuses on systems of care, outcomes of care and quality of life” (more information about QAPI is available on the NORC website).

Consumer Voice created a side-by-side chart (PDF, Excel) comparing the proposed rule with the current regulations and will be providing a sample comment letter and hosting a webinar in the next few weeks. NORC developed a chart that includes references of the Long-Term Care Ombudsman Program (LTCOP) in the current and proposed regulations and related language from the preamble of the proposed rule. Additionally, CMS provided a “Long-Term Care Facilities Cross walk” to show cross references between the current sections and the proposed rule sections (Consumer Voice converted the table to a pdf document) and conducted a national provider call regarding the proposed rule (slides, audio recording, and written transcript are available here).

Comments are due by September 14, 2015 through the Federal Register website and additional information will be provided as it becomes available.