CMS proposes massive regulation revision for LTC

HHS Secretary Sylvia Burwell
HHS Secretary Sylvia Burwell

Individualized meal plans, antipsychotic use and staff training are among the hundreds of proposed changes to regulations released by the Centers for Medicare & Medicaid Services Monday, which officials said they hope will “modernize” the long-term care industry.

The proposed changes, announced in conjunction with the White House Conference on Aging, would help reduce hospital readmissions, cut the rate of infections and increase the overall quality and safety of nursing homes.

“This proposal is just one part of the administration's overall commitment to transform our health system to deliver better quality care and spend our health care dollars in a smarter way,” wrote Health and Human Services Secretary Sylvia M. Burwell in a statement. “Today's measures set high standards for quality and safety in nursing homes and long-term care facilities.”

The proposal includes changes to resident meal plans that would better provide for residents' religious and cultural preferences, accommodate for nutrition and allergy needs and allow residents to eat at non-traditional times. The changes would increase resident choice and quality of life, officials said.

The last time nursing home regulations underwent an update of this scale was in 1991, officials said.

“The existing regulations don't even conceive of electronic communications the way they exist today,” Shari Ling, M.D., Medicare's deputy chief medical officer, told Kaiser Health News. “Also there have been significant advances in the science and delivery of healthcare that just weren't imagined at the time the rules were originally written. For example, the risks of anti-psychotic medications and overuse of antibiotics are now clearly known, when previously they were thought to be harmless.“

The 403-page proposal also includes a “competency-based” approach to making sure facilities meet the CMS requirements. Facilities would be required to assess their own capabilities and resident population, and provide staff with the competencies to meet residents' health needs based on individual person-centered care plans. The proposal states that CMS believes most facilities already make these assessments, but that the changes will ensure they're consistently performed and documented.

In a statement, LeadingAge said while its experts hadn't finished reviewing the full proposal, it supports CMS' proposed steps to ensure facilities have the proper information to provide individualized care for all residents.