8/27/2015. Background Overview Overarching Themes & Highlights of the Proposed Rule Areas of Concern Submitting Comments Resources Questions

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1 OHCA WEBINAR CMS PROPOSED REQUIREMENTS FOR PARTICIPATION AUGUST 27, 2015 Carol Rolf, Senior Partner, Rolf Goffman Martin Lang LLP Mandy Smith, Regulatory Director, OHCA WHAT WE WILL COVER Background Overview Overarching Themes & Highlights of the Proposed Rule Areas of Concern Submitting Comments Resources Questions 1

2 BACKGROUND The requirements for Long-Term Care (LTC) Facilities are the health and safety standards that LTC facilities must meet in order to participate in the Medicare or Medicaid Programs. The current requirements are found at 42 CFR 483 Subpart B. These requirements have not been comprehensively updated since 1991 despite significant changes in the industry. The proposed revisions reflect advances in the theory and practice of service delivery and safety, and implement sections of the Affordable Care Act (ACA)., and formally incorporate many program letter topics/directives that have already been published. We are presenting Highlights, not an exhaustive list of all of the proposed changes. Some issues (legal, therapy, dietary) will be handled by those specific committees. The proposed rule includes a crosswalk to help readers find where existing provisions have been incorporated. OVERVIEW The proposed rule, CMS 3260-P Reform of Requirements for Long-Term Care Facilities, was published in the Federal Register on July 16, To view the proposed rule, please visit: /pdf/ pdf. For additional information on these and other Conditions of Participation, visit Guidance/Legislation/CFCsAndCoPs/index.html?redirect=/CfCsAndCoPs/16 _ASC.asp. 2

3 OVERARCHING THEMES Person-Centered Care Quality Competency-Based Approaches Upgrading the Resident Assessment Process and Approach Alignment with HHS Priorities Involving the Reduction of Antipsychotic Drugs and Rehospitalizations, Improvement of Dementia Care, Infection Control Procedures and Overall Process Improvement Implementation of Previously Enacted Legislation and CMS Program Letters POINTS TO REMEMBER THIS IS PROPOSED, NOT FINAL. OHCA IS COVERING THIS NOW BECAUSE MANY OF THE CONCEPTS WILL REMAIN REGARDLESS OF THE FINAL LANGUAGE. IT IS EXPECTED THAT THE WILL NOT BECOME FINAL FOR ABOUT A YEAR. 3

4 Freedom from abuse, neglect, and exploitation ( ) Definitions Examples Comprehensive Person-Centered Care Planning ( ) New Section 48 Hours Composition of the IDT Team Discharge Planning 4

5 Quality of Care and Quality of Life ( ) Director of Activities NG Tubes Special Needs - Pain Physician services ( ) In-person Evaluation Prior to Unscheduled Transfer to Hospital Delegation of Orders - Dietary 5

6 Nursing services ( ) Sufficient Staffing Behavioral health services ( ) New Section Staffing Facility Assessment Pharmacy services ( ) Definition of Psychotropic Drugs Expansion of Pharmacist Review Attending Physician Review 6

7 Administration ( ) Facility Wide Assessment Incorporation of Aspects of HIPAA Privacy Rule Arbitration Restrictions Quality assurance and performance improvement (QAPI) ( ) New Section QAPI Program Resources 7

8 Infection control ( ) Infection Prevention and Control Program (IPCP) Infection Prevention and Control Officer (IPCO) Antibiotic Stewardship Program Physical environment ( ) Resident Rooms Toilet Facilities Smoking 8

9 AREAS OF CONCERN Too Much, Too Soon Cost to Facility Language is too Broad Survey Implications SUBMITTING COMMENTS Why it is important that you submit your own comments. As you are preparing your comments, be sure to keep the focus on the beneficiaries - - your patients and residents -- rather than on your business or operational results. That's the best way to get CMS to pay attention. The more personalized you can make your comments, the better. Use your own circumstances and your own examples to drive home your message. In other words, tell your story. Submit your comments on behalf of yourself rather than your company or other third party. After you have filed your comments, please let AHCA know on the link provided on the webpage. That way they can keep track of how many comments have been submitted. This will also allow AHCA to recognize you with a special ribbon badge at AHCA's annual convention in San Antonio this October. Be sure to submit your comments prior to the September 14, 2015 deadline. 9

10 RESOURCES Proposed ROP Rule Quality Assurance and Performance Improvement Certification/QAPI/nhqapi.html Conditions of Participation Guidance/Legislation/CFCsAndCoPs/index.html?redirect=/CfCsAndCoPs/16_ASC.as p Guidance/Legislation/CFCsAndCoPs/LTC.html AHCA Comments QUESTIONS? Carol Rolf (216) Rolf@RolfLaw.com Mandy Smith (614) msmith@ohca.org 10