CMS Acting Administrator Andy Slavitt

Binding pre-dispute arbitration agreements have been prohibited under the Centers for Medicare & Medicaid Services’ final rule for long-term care facilities that was released late Wednesday. Long-term care lobbyists have opposed such a move.

The rule, which becomes effective Nov. 28, 2016, brings the first major overhaul to U.S. nursing home regulations since 1991. The new regulations will be implemented in phases, CMS said, with the first “phase-in” period completed by Nov. 28 of this year, followed by additional phases ending on Nov. 28, 2017 and Nov. 28, 2019.

Along with the pre-dispute arbitration ban, the final rule also mandates nursing home operators 1) provide “nourishing, palatable” dietary options that meet residents’ nutritional needs and preferences, 2) create an infection prevention and control program and 3) develop a comprehensive, person-centered care plan for each resident within 48 hours of admission. A nurse aide and a member of the dietary staff must contribute to that care plan, the rule reads.

The rule also includes new and updated regulations on elder abuse, staff competency and discharge planning.

CMS received nearly 10,000 comments on the rule after it was initially proposed in July 2015. Many of them concerned pre-dispute arbitration agreements, CMS Acting Administrator Andy Slavitt said in a blog post.

“The health and safety of residents of long-term care facilities are our top priorities,” Slavitt said. “The advances we are announcing today will give residents and families greater assurances of the care they receive.”