The Centers for Medicare and Medicaid Services (CMS) has released its proposed rule titled Cutting Administrative Requirements for Excellence in Patient Care (CARE). The purpose of this proposed rule is to streamline regulations across the health care system.
CMS proposes the following regulatory revisions relevant to long term care:
- Remove the current weekly respiratory illness data reporting requirement (via the National Healthcare Safety Network [NHSN]), while retaining the requirement for specific reporting during a future Secretary-declared public health emergency.
- Remove the COVID-19 vaccine requirements related to educating staff about the benefits and risks, offering the vaccine, and documenting these actions (for SNFs/NFs and ICFs/IID).
- Streamline the remaining COVID-19 vaccine requirements for residents to be in line with other respiratory viruses (for SNFs/NFs and ICFs).
- Modify the requirement for LTC facilities to provide a state ombudsman with notice of resident transfers related to emergent care.
- Revise the requirements for the active involvement of representatives of direct care staff in conducting the LTC facility assessment.
- Revise the physical environment requirements to exempt existing facilities from the room occupancy and bathroom facility standards.
- Adopt the 2024 editions of National Fire Protection Association (NFPA) LSC and HCFC and the 2022 edition of the ESPS Codes.
- Rescind the following Medicaid institutional payment transparency reporting requirements to reduce burden for states and institutional providers:
- The percentage of Medicaid payments for nursing facility services spent on compensation for direct care workers and support staff.
- The percentage of Medicaid payments for ICFs/IID services spent on compensation for support staff.
CMS is also asking for comments on:
- Allowing LTC facility residents to opt-out of having a discharge notice sent to the state ombudsman office.
- Expanding the scope of practice of physician assistants and nurse practitioners providing care in LTC facilities, especially as it pertains to performing visits currently required by a physician.
- Future policies to address Medicaid institutional workforce shortages and strengthen the institutional workforce.
Comments are due 60 days after publication in the Federal Register. We will continue to analyze the proposed rule in detail and prepare our comments for submission. Please contact regulatory@ahca.org with any questions.