CMS extends enforcement delay to 18 months for some Phase 2 requirements

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CMS announced a one-year delay of Phase 2 penalties this past summer.
CMS announced a one-year delay of Phase 2 penalties this past summer.

The Centers for Medicare & Medicaid Services will be giving long-term care providers 18 months adapt to some of the new requirements for participation without facing penalties, the agency announced late last week.

This past summer, upon release of interpretive guidance for Phase 2 of the new rules, CMS said it would postpone enforcement penalties for one year in response to providers' concerns.

The new 18-month enforcement moratorium applies to a few “unique and separate” F-Tags in order to allow more time to educate providers and surveyors and address issues with the requirements' scope. The overall implementation date for Phase 2 — Nov. 28 — is not affected by the delay, CMS said in a surveyor memo.

The F-Tags included in the moratorium are:

  • F-655 - Baseline Care Plan
  • F-740 - Behavioral Health Services
  • F-741 - Sufficient/Competent Direct Care/Access Staff-Behavioral Health
  • F-758 - Psychotropic Medications related to PRN Limitations
  • F-838 - Facility Assessment
  • F-881 - Antibiotic Stewardship Program
  • F-865 - QAPI Program and Plan related to the development of the QAPI Plan
  • F-926 - Smoking Policies

Noncompliance with these tags will still be cited by surveyors, CMS noted. The agency did not include F-608, which covers reporting reasonable suspicion of a crime, in the moratorium due to “concerns about significant resident abuse going unreported.”

The previously announced freeze of Nursing Home Compare's health inspection rating is expected to begin in early 2018, and will last around one year, CMS said in its memo. The agency also plans on adding summaries of a facility's most recent survey findings, including the number of deficiencies cited or whether a facility had a deficiency-free survey, to Nursing Home Compare early next year.

The penalty moratorium and Nursing Home Compare changes “serve a temporary need to accommodate the implementation of the first major regulatory change to the LTC requirements in over 25 years,” the agency said.