In the greatest standards overhaul since 1991, the Center for Medicare and Medicaid Services (CMS) recently announced sweeping changes in nursing home standards. The changes are enshrined in a new 430 – page document entitled “Proposed Rule” which was released by the CMS on July 16th, 2015.

The Proposed Rule is sets new standards which must be observed by nursing homes which provide long-term care for patients on Medicare and Medicaid. The standards cover everything from patient care and safety to the recruitment and training of caregivers.

In a nutshell, the new standards proposed in the Rule are summarized as follows:

  • Nursing homes should ensure that staffs are trained in preventing elder abuse and caring for patients who suffer from dementia.
  • The homes should ensure that the level and quality of staffing is sufficient to provide the sufficient care for their residents.
  • The homes should equip staff with the skills and competences required to provide person-centered care to patients and residents.
  • The homes are required to provide greater food choice for residents.
  • The homes are required to improve on care planning for all residents. Specifically, they should improve discharge planning including providing all the necessary information for follow-up and ensuring that any receiving services or facilities are given all the essential information.
  • The homes should update their programs for prevention and control of infections. Each home should have a designated officer in charge of infection prevention and control. Each home should also have clear-cut protocols for preventing and controlling infection.
  • The Proposed Rule strengthens the rights of nursing home residents. It places restrictions on arbitration agreements.
  • The Rule bans nursing homes from employing anyone who has ever been disciplined or sanctioned for patient abuse, mistreatment and neglect. It also bans them employing anyone with a history of theft.
  • The Rule proposes that thorough background checks be carried out all professionals before they can be hired. The background checks should help eliminate those who are banned from working in nursing homes.
  • The Rule expands federal oversight into nursing homes. The aim is to reduce the incidences of fraud and abuse in the homes.
  • The Rule also mandates nursing home to develop and implement policies which are aimed at preventing abuse, maltreatment, and neglect of patients and residents.
  • The Rule proposes mandatory review of how medications are used. It proposes that a pharmacist carries out a thorough review of each resident’s chart once every six months. The review is aimed at identifying any irregularities and unnecessary medications. Such irregularities should be reported to the authorities.
  • The Rule proposes a restriction on the use of certain kinds of medications – specifically psychotropic drugs. It proposes to limit their use to situations where they are absolutely necessary.
  • The Rule proposes stricter compliance requirements for nursing homes. It proposes all the home’s facilities meet the Quality Assurance and Performance Improvement (QAPI) standards.

In a nutshell, the Proposed Rule places stricter standards for nursing homes. If implemented, these standards will likely improve the overall quality of care received by nursing home patients and residents. However, these improvements won’t come cheap. The CMS estimates that the nursing home industry will incur $729 million to implement the new standards within the first year of their adoption.