CMS RELEASES OVERHAUL OF RULES:
Revisions establish new requirements for LTC facilities
The Centers for Medicare & Medicaid Services (CMS) released the final version of a broad-based regulatory update amending the Nursing Home Requirements of Participation. The comprehensive Final Regulations represent the most significant change to the delivery of nursing home care since OBRA '87. These revisions are an integral part of efforts by CMS to achieve broad-based improvements, both in the quality of health care provided through federal programs and in patient safety. In addition, CMS anticipates the revisions will potentially improve efficiency and effectiveness, enhance resident quality of care and quality of life, and improve clinical outcomes.
The Final Regulations obligate many important changes in facility operations, from initial care planning to resident discharges, and seek to target rehospitalizations, facility-acquired infections, overall quality of care and resident safety. CMS estimates that the projected cost of the regulations will be about $62,900 per facility in the first year and $55,000 per facility each subsequent year. While the bulk of the new and amended requirements are effective November 28, 2016 (Phase 1), some requirements, due to their complexity, will be phased-in and fully implemented one to three years after the effective date (Phases 2 and 3).
Major Highlights Include:
- Revisions requiring Comprehensive Person-Centered Care Planning, including a baseline interim care plan for each resident within 48 hours of admission, and discharge assessment and planning included in the comprehensive care plan;
- A new requirement for a Facility Assessment, updated at least annually, to determine necessary resources to provide competent care for residents during day-to-day operations and emergencies, including staff competencies necessary to provide the level and types of care needed for the facility's resident population;
- Revisions related to the use of restraints and specific requirements related to the use of bed rails, as well as, a new requirement to conduct regular inspections of bed frames, mattresses, and bed rails as part of a facility's maintenance program to identify areas of possible entrapment and to ensure that the bed’s dimensions are appropriate for the resident's size and weight;
- Implementation of Quality Assurance and Performance Improvement (QAPI) provisions under the Affordable Care Act, requiring development, implementation, and maintenance of an effective, comprehensive, data-driven QAPI program that focuses on systems of care, outcomes of care and quality of life; and
- Revisions requiring the establishment of an infection prevention and control program.
- A prohibition on the use of pre-dispute binding arbitration agreements was included in the Final Regulations, but the American Health Care Association successfully petitioned for an injunction temporarily suspending implementation of the provision.
Steps Facilities Can Take To Comply With The New Requirements
"Every day our products and services help facilities prevent falls, pressure injuries and other unfortunate outcomes that can potentially lead to litigation," said Doug Ferguson, Senior Vice President of Global Product Development at Joerns Healthcare.
"Unfortunately, not all of these adverse events are avoidable," said National Clinical Director, Julia Melendez, RN, BSN, JD, CWOCN. "In those instances, facilities need to demonstrate that they did everything in their power to prevent the outcomes which can form the basis for the litigation. They need to demonstrate they had the best available equipment, the proper training for their staff, and ongoing support. And Joerns can help with that."
Joerns Healthcare, a vertically integrated product designer, manufacturer, distributor and direct service provider, supplies an unmatched suite of advanced injury and wound prevention products, and patient care and handling products. Joerns complements its offerings with first-rate clinical education and support, thereby helping facilities achieve positive outcomes and successfully defend themselves in litigation should unavoidable events occur.
"Facilities that choose us as a partner can present documentation on the quality and compliance of our products," Ferguson said. "They can present documentation saying their staff received proper training and ongoing support. All of these benefits that derive from working with Joerns Healthcare may lead to a successful defense in light of an unavoidable, adverse outcome."
Learn more about the safety and security Joerns' products and services can bring to your organization. Call 800-826-0270 or complete this form to speak with a Joerns Healthcare representative.