Legislative and Regulatory Updates and Resources
"The following legislative and regulatory information will be updated as information becomes available from CMS and other credible sources."
Updated SNF Advance Beneficiary Notice of Non-coverage (ABN) will be mandatory for use on 10/31/2024
“With the help of our contractors, we revised the SNF ABN, Form CMS-10055, and the form instructions. The SNF ABN form and instructions are located in the download section and are available for immediate use, but will be mandatory for use on 10/31/2024.”
Article by: CMS.gov – September 11, 2024
Now Available: Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual
“This is an informational document that includes hyperlinks (links) that have been identified as requiring an update over the lifetime of the MDS 3.0 RAI User’s Manual v1.19.1, effective October 01, 2024. Due to external webpage changes, links may occasionally redirect or become unreachable, or the information provided on the webpage may change. To ensure all links remain current, a list of non-functional/out-of-date links has been compiled, each with an up-to-date replacement link. Replacement pages for each affected page of the MDS 3.0 RAI User’s Manual v1.19.1 can be found following the list.”
Article by: CMS.gov – September 4, 2024
Noncompete agreements aren’t going anywhere. What to know if you sign one
“A Texas judge late last month struck down a nationwide ban on noncompete agreements that was supposed to take effect this Wednesday.
Existing noncompete agreements will therefore now remain in place. And employers may still ask you to sign one as a condition of employment. That is, unless and until a higher court decides otherwise, or Congress passes a law prohibiting it. But, if that does happen, it could take years.”
Article by: CNN – September 2, 2024
AHCA, HHS seek quick timeline in federal staffing mandate case
“The American Health Care Association, LeadingAge and four other parties in a lawsuit challenging the federal nursing home staffing mandate have told the case’s judge they expect a decision to be reached on motions alone and proposed a schedule that could lead to a resolution as early as January.
The motion, filed Friday, reveals AHCA’s intention to seek summary judgment by mid-October. Summary judgment allows a judge to decide a case based on submitted briefs and oral arguments, without the need to advance to a trial.“
Article by: McKnight’s Long Term Care News – August 14, 2024
First facility assessment deadline leaves gaping questions about surveyor intent
“After three months of preparation, skilled nursing providers across the country were required late last week to complete their first enhanced facility assessment.
The broader look at resident and staffing needs will be used to support the federal staffing mandate, whose more specific hourly staffing requirements begin to come into play in 2026.”
Article by: McKnight’s Long Term Care News – August 12, 2024
CMS Issues FY 2025 SNF Final Payment Rule
Click Here to see a one page summary of the final rule, prepared by AHCA
CMS increase abilities to fine nursing homes, hikes Medicare pay by 4.2 percent
“Nursing homes will be getting a 4.2% Medicare Part A pay raise under the fiscal 2025 final pay rule issued Wednesday. Providers also will be facing a more aggressive fines system, with civil monetary penalties now applicable in more instances.”
Article by: McKnight’s Long Term Care News – July 31, 2024
15 health systems dropping Medicare Advantage plans
“Medicare Advantage provides health coverage to more than half of the nation’s seniors, but some hospitals and health systems are opting to end their contracts with MA plans over administrative challenges.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers.”
Article by: Becker’s Hospital CFO Report – July 22, 2024
Nursing home reform could move to the ‘side burner’ with Harris focused on reproductive rights
“When the Biden administration dropped the final version of its nursing home staffing mandate in April, it was Vice President Kamala Harris who suddenly became the face of the initiative.“
Article by: McKnight Long Term Care News – July 22, 2024
CMS to post more nursing home ownership data, facility health data for first time when it unfreezes star ratings this month
“The Centers for Medicare & Medicaid Services announced Monday that it will begin posting certain nursing home ownership information, as well as aggregated MDS data for all residents at a facility, both for the first time, and issue new guides for consumers, on the Nursing Home Compare website.”
Article by: McKnight Long Term Care News – July 1, 2024
Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care
“Skilled nursing providers have been sounding the alarm for years on Medicare Advantage coverage access, especially when informed by AI and other algorithms. Sector leaders have frequently noted that these methods can deny or prematurely end coverage for patients who need it to afford necessary long-term care.”
Article by: McKnight Long Term Care News – June 26, 2024
CMS issues first nursing home staffing rule enforcement guidance
“The Centers for Medicare & Medicaid Services has issued updated guidance that surveyors will use to weigh nursing homes’ compliance with expanded facility assessment requirements included in the minimum staffing rule.”
Article by: McKnight Long Term Care News – June 19, 2024
California bill requires AG approval of private equity healthcare deals
“A California bill that would require private equity firms and hedge funds to obtain prior approval from the state attorney general for certain healthcare-related transactions is one step closer to becoming law following the State Assembly’s passage of the legislation late last month..“
Article by: McKnight Senior Living – June 7, 2024
AHCA Files Lawsuit Against Federal Staffing Mandate
“The American Health Care Association (AHCA), joined by the Texas Health Care Association (THCA) and several Texas long term care facilities filed a lawsuit late Thursday in the Northern District of Texas against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) for exceeding their statutory authority and arbitrarily and capriciously issuing the Minimum Staffing Standards for Long-Term Care Facilities final rule.“
Article by: AHCA – May 24, 2024
Rare congressional review aims to undo nursing home staffing mandate
“A rare congressional resolution was introduced in the House of Representatives Tuesday that presents a new opportunity for federal lawmakers to block the nursing home staffing mandate.
Lawmakers can use the Congressional Review Act to nullify regulations enacted by executive branch agencies. Reps. Michelle Fischbach (R-MN) and Greg Pence (R-IN) introduced a measure calling for a review of the nursing home rule, which they have also moved to block through proactive legislation.”
Article by: McKnight’s Long Term Care News – May 16, 2024
Bills that add CNA training flexibility, extend telehealth privileges advance toward full House vote.
“Two key bills that would allow nursing homes more flexibility to train certified nursing assistants onsite and extend telehealth access through 2026 cleared a major hurdle at a markup session before the US House Ways and Means Committee Wednesday.“
Article by: McKnight’s Long Term Care News – May 9, 2024
Federal Trade Commission Announces Rule Banning Non-competes.
“Today, the Federal Trade Commission issued a final rule to promote competition by banning noncompetes nationwide, protecting the fundamental freedom of workers to change jobs, increasing innovation, and fostering new business formation.“
Article by: Federal Trade Commission – April 23, 2024
EXTRA: CMS publishes rule outlining final staffing requirements (and possible exemptions).
“The Centers for Medicare & Medicaid Services said it would exempt nursing homes from having registered nurse coverage for up to 8 out of 24 hours a day “under certain circumstances,” unveiling a critical new detail in the second part of today’s staffing rule rollout.“
Article by: McKnight Long Term Care News – April 23, 2024
BREAKING: CMS increases hours to 3.48 in final staffing rule.
“Nursing homes will be required to deliver 3.48 hours of daily direct care per patient under a final staffing mandate issued this morning.
A White House statement on the rule today said that 3.0 hours must be split between registered nurses at 0.55 hours and 2.45 hours for certified nurse aides. The remaining time was not immediately defined by the White House release, and the full rule text was not available.“
Article by: McKnight Long Term Care News – April 22, 2024
Quality Reporting Program Changes to Bring Nursing Homes ‘Into the Realm of Health Equity’.
“CMS is proposing that SNFs will be required to report one item related to living situation, two items related to food, and one item related to utilities as standardized patient assessment data under the SDOH category.“
Article by: Skilled Nursing News – April 18, 2024
CMS’ New TEAM Payment Model Covers Nursing Home Stays, But Hospitals Are in the Driver’s Seat.
“The Centers for Medicare & Medicaid Services (CMS) is testing out a payment model that would cover all costs associated with an episode of care, including a skilled nursing stay, but it appears that select hospitals would be in the driver’s seat if approved.“
Article by: Skilled Nursing News – April 11, 2024
CMS proposes 4.1 percent nursing homes pay boost; staffing minimum not addressed
“The Centers for Medicare & Medicaid Services Thursday proposed a 4.1% pay increase for nursing homes in fiscal 2025 but declined to issue an update on its staffing minimum proposal as part of its annual payment rule proposal.
In addition, the agency has proposed an expanded Civil Monetary Penalty process that would allow “for more per instance and per day” to be imposed.“
Article by: McKnight Long Term Care News – March 29, 2024
Inside the Tighter CMS Requirements for the Nursing Home Quality Reporting Program.
“The Centers for Medicare & Medicaid Services (CMS) hosted a webinar Tuesday focused on data submission related to quality reporting requirements for nursing homes. The session centered on three primary data sources: Minimum Data Set (MDS), Medicare Fee-for-Service claims, and the CDC’s National Healthcare Safety Network (NHSN).”
Article by: Skilled Nursing News – March 26, 2024
More Capital Flows into Skilled Nursing as Institutional Investors See It as ‘Infrastructure’.
“According to Northwind Group’s Ran Eliasaf and Jonathan Slusher, investments in nursing homes are benefiting from the view change for the entire health care sector in general, but also due to a realization among investors that nursing homes are highly regulated – and operationally sound.”
Article by: Skilled Nursing News – March 15, 2024
HHS takes steps to address recent cyberattack; LTC still reeling from aftermath.
“HHS’ first priority is to help coordinate efforts to avoid disruptions to care throughout the healthcare system,” HHS spokespersons said. “This incident is a reminder of the interconnectedness of the domestic healthcare ecosystem and of the urgency of strengthening cybersecurity resiliency across the ecosystem.”
Article by: US Department of HHS and McKnight’s Long Term Care News – March 7, 2024
CDC Shortens Recommended COVID Isolation Period.
The CDC recommends “returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication.”
Article by: (HealthDay News) McKnight’s Long Term Care News- March 4, 2024
False Claims notch a record year, increasing threat to skilled nursing facilities.
Healthcare providers were forced to pay a historic $2.7 billion to resolve federal False Claims Act allegations last year, an escalation that will likely allow the government to support even more investigations in years to come.
There are plenty of factors that could point to more investigations in the post-acute and long-term care space this year and beyond.
Article by: McKnight’s Long Term Care News- February 26, 2024
Expect another Five-Star freeze amid nursing home survey delays, experts warn.
Staffing measures used to calculate nursing homes’ federal ratings will freeze in April, further complicating a system based on often outdated and constantly changing metrics, experts warned last week.
Article by: McKnight’s Long Term Care News- February 20, 2024
CCRCs facing financial threats in their skilled care units, but there are silver linings: Experts
Facing the mounting financial challenges of providing skilled care on their campuses, continuing care retirement communities should carefully weigh a variety of tactics and the particularities of local markets, a panel of experts advised Thursday.
Article by: McKnight’s Long Term Care News- February 16, 2024
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