Changes to the standards for long-term-care facilities that receive Medicare and Medicaid funding are coming, a move recently announced by the Centers for Medicare and Medicaid Services to raise the quality of care in nursing homes across the U.S.
The list of updates, released last week, addresses a wide range of topics, including the use of non-psychotropic drugs and the standards that need to be met for a patient to be discharged. Procedural changes range from adjustments in the arbitration process to new forms for reporting abuse.
Many of the new changes had to do with COVID-19 prevention, including the new requirement that long-term-care facilities have an infection preventionist on staff. CMS Administrator Chiquita Brooks-LaSure said problems nursing homes faced during the pandemic were a motivating factor in updating the standards.
“As the COVID-19 pandemic highlighted, we have a pressing moral responsibility to ensure that residents of long-term-care facilities are treated with the respect and dignity they deserve,” she said in a statement. “CMS is proud to be leading President Biden’s initiative to improve the safety and quality of care in the nation’s nursing homes, and this set of improvements is our next step toward that goal.”
As Brooks-LaSure suggests, the higher standards are part of a push by the Biden Administration, introduced in February shortly before the State of the Union, to raise the quality of nursing home care in the United States, particularly in response to a large number of private equity investments in long-term-care facilities.
The highlight of the President’s proposal earlier this year was higher staffing levels at nursing homes, but the most recent set of rules does not set specific staffing standards or define consequences for understaffed facilities. However, one of the most recent changes is a requirement that nursing homes make staffing data available during inspections.
“Today’s guidance furthers this goal but is just one piece of the implementation of the action plan announced in the State of the Union, which includes, among other things, new rulemaking to require minimum staffing levels in nursing homes,” reads the CMS statement. “To begin helping address the staffing issue while the rulemaking process is underway, CMS added new requirements for surveyors to incorporate the use of Payroll Based Journal staffing data for their inspections. This will help better identify potential noncompliance with CMS’s nurse staffing requirements, such as lack of a registered nurse for eight hours each day, or lack of licensed nursing for 24 hours a day.”
The new rules are set to go into effect in October, when surveyors will begin using them during inspections and the State Operating Manuals will be adjusted. Surveyors are scheduled to begin training on the new system in September.