You Are Here:Home/Resources/DNS Navigator/DNS Navigator Details
The Centers for Medicare & Medicaid Services (CMS) has published two key rules impacting the requirements for participation for Medicare- and/or Medicaid-certified long-term care facilities:
Revision of Requirements for Long-Term Care Facilities: Arbitration Agreements Final Rule; and
Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency Proposed Rule.
The Arbitration Agreements Final Rule, which goes into effect this September 16, adopted the 2017 proposed rule with some changes. CMS has repealed the prohibition against pre-dispute, binding arbitration agreements, but the new regulations “specify that a facility must not require any resident or his or her representative to sign an agreement for binding arbitration as a condition of admission to, or as a requirement to continue receiving care at, the facility and must explicitly inform the resident or his or her representative of his or her right not to sign the agreement as a condition of admission to, or as a requirement to continue receiving care at, the facility.”
The countdown is on. There are only a few short months left until November 28, 2019—the implementation date of Phase 3, and the date by which facilities must have designated the individual who will be responsible for Infection Prevention and Control Programs (IPCPs)—mandatory elements under the requirements of participation in Medicare and Medicaid.
Are you fully prepared?
Effective November 28, new Quality Assurance and Performance Improvement/Quality Assurance and Assessment (QAPI/QAA) regulations will go into effect as part of the Phase 3 rollout of the revised Medicare/Medicaid requirements of participation. Abuse/neglect is the first care area where the Centers for Medicare & Medicaid Services (CMS) makes an explicit connection between QAPI/QAA and facility policies and procedures (P&Ps). Specifically, providers will need to ensure that the written policies and procedures they develop and implement under F607 (Develop/Implement Abuse/Neglect, etc. Policies) to prevent the abuse, neglect, and exploitation of residents, as well as the misappropriation of resident property, “establish coordination with the QAPI program required under §483.75,” according to §483.12(b)(4) of the Code of Federal Regulations (CFR).
Establishing systems for collecting and monitoring data, as well as systematically analyzing and acting on that data, will play a critical role in complying with the updated regulations for quality assurance and performance improvement (QAPI) and quality assessment and assurance (QAA) that will roll out this November 28 as part of the Phase 3 implementation of the revised requirements of participation for Medicare- and Medicaid-certified nursing homes. At present time, the Centers for Medicare & Medicaid Services (CMS) hasn’t yet issued a revised Appendix PP, “Guidance to Surveyors for Long-term Care Facilities,” of the State Operations Manual (SOM), but the existing Appendix PP already cites which data-related sections of the Code of Federal Regulations (CFR) will go into effect under the following F-tags:
The National Academies of Sciences Engineering and Medicine (NASEM) hosted a Town Hall meeting in Chicago, IL on Friday, June 7 as part of the Future of Nursing: 2020-2030 project. The Future of Nursing project aims to “chart a path for the nursing profession to help our nation create a culture of health, reduce health disparities, and improve the health and wellbeing of the U.S. population in the 21st century.” Together with their Future of Nursing Campaign for Action and information about the latest in science and technology, they will put together a final report to assess “the capacity of the profession to meet the anticipated health and social care demands from 2020 to 2030.”
In the realm of the revised survey process, an interesting F-tag has joined the list of the most frequently cited deficiencies across the country. The tag is F-842, and in case that regulatory number is not immediately familiar, it has to do with documentation: “Resident Records – Identifiable Information.”
Given our profession’s consistent focus on documentation, does that come as a surprise? It certainly did for this writer! Between January 2018 and April 2019, F-842 has been cited nearly 3,000 times, across all CMS Survey and Certification Regional Offices. In 2019 so far, there have been 250 deficiencies cited under F-842. Long-term care has long been required to maintain residents’ personal privacy and keep medical records confidential. This is not a new requirement of participation, so what is happening? Many of the citations stem from the medical record not being accurate and complete, which is a component of F-842.
Below are brief descriptions of a few of the cited deficiencies.
To access this article, please login or sign up for a membership.