Overview of Proposed Rule to Overhaul Nursing Facility Requirements for Participation in Medicare and Medicaid

On July 16, 2015, the U.S. Department of Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) published a proposed rule to revise Medicare and Medicaid participation requirements for nursing facilities. The proposed regulations are the first comprehensive revisions to skilled nursing and long term care regulations since 1991 and include substantial changes and reorganization. Much of the 103 page proposed rule, if adopted, will codify existing facility and surveyor policies and practices.  However, there are a number of substantive changes among the many new rules. The Summer 2015 edition of the VHCA Legal Quarterly focuses on several key areas where proposed requirements are likely to change current facility practices significantly, including: 

  • The facility assessment
  • Staffing
  • Medications
  • Transfer and discharge
  • Care plans
  • QAPI, infection control, and compliance

To read the Summer 2015 edition of the VHCA Legal Quarterly in its entirety, click here.*

On August 11 from 2:30 p.m. – 4:00 p.m., CMS is hosting a call for providers and stakeholders during which the agency will briefly walk through the many changes in the proposed rule.  The agenda for the call is:

  • Highlights of the proposed rule
  • Overarching themes of the proposed rule
  • Methods for reviewing and commenting on the proposed rule.

A question and answer session will follow the presentation. Registration is required.  Additional information is available on the CMS website.

HHS is accepting comments on the proposed rule.  Comments must be received by 5:00 p.m. on September 14.  The American Health Care Association (AHCA) has prepared helpful tips on how to submit comments, which are available here

*The Summer 2015 edition of the VHCA Legal Quarterly, "CMS Proposes Broad Overhaul to Nursing Facility Requirements for Participation in Medicare and Medicaid" was written by Nathan Mortier and Peter Mellette with Mellette PC in Williamsburg.  This article is for general educational purposes only. It is not legal advice specific to any situation you may have. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice.