Launch of the CMS Beneficiary Notices Initiative (BNI) Mailbox Portal for Beneficiary Notices and Related Policy Questions

This message is to announce the launch of the new CMS Beneficiary Notices Initiative (BNI) mailbox portal for beneficiary notices and related policy questions.  Please note this mailbox portal replaces the BNI mailbox, BNImailbox@cms.hhs.gov.  The purpose of this new BNI mailbox portal is to provide a more efficient method for responding to provider, industry, and stakeholder questions. 

The new BNI mailbox portal provides links to a variety of resources and links to other CMS mailboxes and e-mail addresses.  CMS encourages you to review the available resources before submitting a question to ensure that we have not already provided information on the specific topic in question.  Please also refer to the list of other CMS mailboxes and e-mail addresses to ensure that you direct your question to the most appropriate area of expertise. 

Medicare and Medicaid Programs: Revision of Requirements for Long Term Care Facilities: Arbitration Agreements

ACTION: Final rule.

SUMMARY: This final rule amends the requirements that Long-Term Care (LTC) facilities must meet to participate in the Medicare and Medicaid programs. Specifically, we are repealing the prohibition on the use of pre-dispute, binding arbitration agreements. We are also strengthening the transparency of arbitration agreements and arbitration in LTC facilities. This final rule supports residents’ rights to make informed choices about important aspects of their health care. 

Medicare and Medicaid Programs: Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency, and Transparency

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed rule.

Areas of Major Provisions:

a. Requirements for Participation

Resident Rights (§483.10)

Admission, Transfer, and Discharge Rights (§483.15)

Nursing Services (§483.35)

Behavioral Health (§483.40)

Pharmacy Services (§483.45)

Food and Nutrition Services (§483.60)

Administration (§483.70)

Quality Assurance and Performance Improvement (§483.75)

Infection Control (§483.80)

Compliance and Ethics Program (§483.85)

Physical Environment (§483.90)

Technical Corrections

b. Survey, Certification, and Enforcement Procedures

Informal Dispute Resolution and Independent Informal Dispute Resolution (§488.331 and §488.431)

Civil Money Penalties: Waiver of Hearing, Reduction of Penalty Amount (§488.436)

Phase 3 Implementation of Overlapping Regulatory Provisions

Purpose of these resources This is a comprehensive, but not all inclusive, list of resources that may be helpful for nursing homes as they work to ensure that residents who are trauma survivors receive culturally competent, traumainformed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident (per §483.25(m) requirement that will be implemented beginning November 28, 2019).

Who should use these resources? Nursing home leadership teams may assign responsibility to a person, such as a social worker, to review the resources below, identifying those that might be helpful for a) leadership, staff, and/or resident/family education, or b) behavioral/emotional care policy or program development or revision. 

Why this is important? The included resources provide information that will help nursing homes to build capacity among interdisciplinary team members to deliver holistic resident care, being sensitive to how a range of experiences over the resident’s life may relate to their current physical, emotional, and behavioral health status. Trauma is common throughout human experience, and we need to respond with empathy and understanding. Providing trauma informed care can help staff to avoid re-victimization of those who have survived trauma and create an environment where the individual feels safe and secure.