There are no new regulations related to resident room capacity. Also, CMS memorandum QSO-22-19-NH included recommendations related to resident room capacity. Phase 3 requirements such as Trauma Informed Care, Compliance and Ethics, and Quality Assurance Performance Improvement (QAPI) as well as the clarifications of Quality of Life and Quality of Care, Food and Nutrition Services, and Physical Environment are also included in this guidance. Clarifies timeliness of state investigations, and communication to complainants to improve consistency across states.Clarifies the application of the “reasonable person concept” and severity levels for deficiencies.Clarifies existing requirements for compliance when arbitration agreements are used by nursing homes to settle disputes.IP specialized Training is required and available.IP role is critical to mitigating infectious diseases through an effective infection prevention and control program.The IP must physically work onsite and cannot be an off-site consultant or work at a separate location.While the requirement is to have at least a part-time IP, the IP must meet the needs of the facility.Requires facilities have a part-time Infection Preventionist.Addresses unnecessary use of non-psychotropic drugs in addition to antipsychotics, and gradual dose reduction.Addresses situations where practitioners or facilities may have inaccurately diagnosed/coded a resident with schizophrenia in the resident assessment instrument.Potential Inaccurate Diagnosis and/or Assessment Imports guidance related to visitation from memos issued related to COVID-19, and makes changes for additional clarity and technical corrections.Uses payroll-based staffing data to trigger deeper investigations of sufficient staffing and added examples of noncompliance.Addresses rights and behavioral health services for individuals with mental health needs and SUDs.Mental Health/Substance Use Disorder (SUD) : Clarifies requirements related to facility-initiated discharges.Clarifies compliance, abuse reporting, including sample reporting templates, and provides examples of abuse that, because of the action itself, would be assigned to certain severity levels.Today’s updates to guidance are just one piece of CMS’s ongoing effort to implement President Joe Biden’s vision to protect seniors by improving the safety and quality of our nation’s nursing homes, as outlined in a fact sheet released prior to his first State of the Union Address in March 2022. In addition, CMS is revising its guidance to State agencies, to strengthen the management of complaints and facility reported incidents. To further support the implementation of the Long-Term Care (LTC) Facilities Requirements for Participation, which were published in 2016, CMS is issuing surveyor guidance which clarifies specific regulatory requirements and provides information on how compliance will be assessed.
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