CMS has released a proposal to update the quality and safety requirements that nursing homes and skilled nursing facilities must meet to qualify for government payments. If finalized, it would be the first time such requirements were updated since 1991.
The proposals were revealed Monday at the White House Conference on Aging.
The proposed changes run the gamut of life in a nursing home. The following are eight of the proposed changes, highlighted by CMS and by Kaiser Health News.
1. The new rules would require nursing home staff to be trained to care for people with dementia and to prevent elder abuse.
2. A facility's pharmacist would need to monitor drugs that are prescribed for "excessive" time periods or other issues and require the physician to address the issue or explain in the medical record why the drug is necessary, according to KHN. This is aimed at cutting the inappropriate use of antipsychotic drugs.
3. Residents would be able to choose their roommates in a nursing facility. "Our proposed provision would provide for a rooming arrangement that could include a same-sex couple, siblings, other relatives, long-term friends or any other combination" as long as the staff can accommodate the arrangement reasonably, KHN reported.
4. Nursing homes would have to provide more food choices to residents, like snacks or alternative meals for residents who want to eat before or after scheduled meals.
5. Nursing homes would be required to have an infection prevention and control officer and an antibiotic stewardship program, including antibiotic use protocols and a system to monitor their use.
6. Discharge planning would be improved by involving the facility's team in the process, considering the caregiver's capacity, giving residents the information they need for follow-up care and ensuring care instructions are delivered to any receiving facilities.
7. Nursing homes would be required to report staffing levels, which would then be reviewed by Medicare officials for adequacy, according to KHN.
8. Residents' rights would be strengthened under the proposed changes, including placing limits on when and how binding arbitration agreements can be used.
There is also a section on electronic health records in the proposed changes, according to KHN.
The proposed changes will be published in a proposed rule in the July 16 Federal Register. There is a 60-day comment period on the revisions.