Revisions to Phase 3 of the Requirements of Participation for long-term care facilities aim at reducing paperwork, giving staff more time for direct care.
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that would remove some requirements of participation identified as “unnecessary, obsolete, or excessively burdensome” on long-term care facilities (LTCFs). According to CMS, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3374-P) would “increase facilities’ ability to devote their resources to improve resident care…. Many of the proposed provisions would simplify and/or streamline the Medicare health and safety standards long-term care facilities must meet in order to serve their residents.” Read on for details about key revisions that would impact staffing, training, and other others issues of interest to HR and other leaders.
These revisions, CMS Administrator Seema Verma has stressed, are part of the agency’s efforts to promote the concept of “putting patients over paperwork” and reducing unnecessary administrative burdens on facilities. The rule would:
· Reduce the requirements for individuals responsible for the compliance and ethics programs. Specifically, it would remove the requirements for a compliance officer and compliance liaisons, as well as specific duties of the grievance officer. It also would reduce the frequency of compliance and ethics program reviews.
· Allow directors of food and nutrition services with two or more years of experience to continue in this role without obtaining additional certification. However, newly hired directors or those with less than two years of experience would need to complete, at a minimum, a course in food safety and management.
· Allow facilities greater flexibility in tailoring their Quality Assurance Program Improvement (QAPI) programs to their specific, individual needs by eliminating prescriptive requirements.
· Update informal dispute resolution by adding timeframes on process and increased provider transparency.
· Reduce paperwork by requiring facilities to send discharge notices to the State LTC Ombudsmen for “facility-initiated involuntary transfers and discharges” only.
To give facilities enough time to respond to these proposed changes, CMS has proposed delaying the implementation of certain aspects of Phase 3 of the Requirements of Participation (RoP) for one year.
“We are closely reviewing the proposed rule in more detail. We are pleased that CMS preserved important advances in these regulations such as those addressing infection control and prevention and resident rights. At the same time, CMS has recognized the need to eliminate regulations that result in unnecessary paperwork,” said Dr. David Gifford, senior vice president of quality and regulatory affairs and chief medical officer at the American Health Care Association. He added, “Many of the changes in this proposed rule will allow caregivers to devote more time to resident care instead of completing paperwork that does not help keep residents safe and happy.” Elsewhere, Katie Smith Sloan, LeadingAge president and CEO, said, “We are pleased that the proposed rule would allow greater flexibility for nursing homes on some of the RoPs III [Phase 3] requirements. We have pointed out to CMS that requiring nursing homes to designate specific staff as compliance officers, compliance liaisons, and grievance officers would take valuable staff time away from caring for residents, and we appreciate CMS’s agreement on this point.”
CMS will accept comments on the proposed rule until September 16, 2019 here.
