Most continuing care retirement communities are not 'isolating' settings, CMS clarifies in guidance on recent regulation

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Continuing care retirement communities don't create the same problem of isolation as skilled nursing facilities, according to new guidance on a recently finalized Medicaid regulation.

In January, the Centers for Medicare & Medicaid Services issued a final rule on home- and community-based services. This rule mandated person-centered care for Medicaid beneficiaries receiving HCBS, and it defined which settings would be eligible to participate in an HCBS program. These settings should be integrated into the community and provide residents with full access to the community, the rule stated.

Nursing centers were specifically excluded as a viable HCBS setting in the final rule. Continuing care retirement communities — which often include skilled nursing services — are a different story, according to a memorandum released Thursday.

In part because CCRCs include independent living residents as well as those receiving home- and community-based services, they “do not raise the same concerns about isolation” as similar settings, such as group homes that are co-located on the same campus, the guidance document stated.

The memorandum was part of a “compliance toolkit.” Other documents included assessment questions for whether a particular setting meets HCBS criteria, and a schematic illustration of the process for receiving an HCBS Medicaid waiver under the more stringent guidelines now in place.

Click here to access the complete toolkit.

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