1. Proposed Nursing Home Staffing Rule Faces Lengthy Review Process: Federal regulators have revealed that finalizing the proposed nursing home staffing rule, titled “Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting,” may take up to three years. The Fall 2023 Unified Agenda has set a deadline of September 2026 for the completion of the rule, which mandates nursing homes to undergo facility assessments, meet specific hourly staffing thresholds for certified nurse aides and registered nurses, and maintain around-the-clock staffing of RNs. The Centers for Medicare & Medicaid Services (CMS) received nearly 47,000 public comments on the rule, including suggestions for alternative staffing approaches. Some provider groups had anticipated a longer process, and the latest Unified Agenda indicates the potential for an extended review period, with the CMS having up to three years to finalize the rule.
2. Department of Health and Human Services Prioritizes Nursing Home Reform: The Department of Health and Human Services (HHS) has outlined its regulatory plans, emphasizing the Biden-Harris Administration’s Nursing Home Reform Action Plan. The HHS aims to enhance the safety and quality of care in nursing homes through the finalization of rules that establish minimum staffing standards, protect residents, prevent fraud and abuse, and ensure transparency in ownership and management information for Medicare and Medicaid nursing facilities. Strengthening high-quality services for older adults is among the department’s key priorities. The regulatory plan also includes initiatives to address crime in long-term care facilities, requiring staff to report suspicions to HHS and law enforcement, with potential penalties for non-compliance and retaliation.
3. Additional Changes in Long-Term Care Facilities Oversight: In addition to staffing-related reforms, the Fall 2023 Unified Agenda introduces further changes in oversight for long-term care facilities. A proposed rule would compel staff in these facilities to report any reasonable suspicion of a crime against a resident, with corresponding obligations and protections outlined. Violations could lead to civil money penalties and exclusion from Medicare participation. The department also commits to establishing new appeals processes related to the three-day stay requirement for skilled nursing coverage under traditional Medicare, following a court order. While no specific timeline is provided for this rule, the HHS aims to implement comprehensive measures to ensure the well-being, safety, and quality of care for individuals in long-term care settings.