Long Term Care Federal Regulations
Federal Regulations for Long Term Care Facilities Centers for Medicare & Medicaid Services, Department of Health and Human Services, Standards and Certification, Public Health, Requirements for states and Long Term Care Facilities, Title 42, Chapter IV, 400-699
State Operations Manual Appendix PP – Guidance to Surveyors for Long Term Care, Rev. 208, 10-21-22
Skilled Nursing Facility PPS Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities
Nursing Home Quality Initiative Resources about Minimum Data Set (MDS), Care Compare, payment, quality measures, survey and certification information for providers
Patient Driven Payment Model, PDPM Clinical categories used for PT, OT, SLP, NTA components, and ICD-10 code mappings
Care Compare Quality measures for consumers, providers, states, and researchers to compare information on nursing homes
HIPAA Administrative Simplification Regulation Text 45 CFR Parts 160, 162, and 164, March 2006, Complete version with table of contents, HIPAA survival guide, resources, toolkits
CMS Regulatory Changes 2022
Surveyors will use the Reasonable Person Concept to gauge the effect a deficiency had on a reasonable person in the resident’s position when it may not be readily determined from the resident.
Staff Training based on facility assessments of learning needs must be provided for staff, contract employees, and volunteers.
CMS is urging a maximum Room Occupancy of two in each room, and encourages facilities to allow for more single occupancy rooms for residents.
Facility staff should be trained in signs and symptoms of possible Substance Abuse, and be prepared to administer naloxone, initiating cardiopulmonary resuscitation as appropriate, and contacting emergency medical services.
Facilities should identify a resident’s history of trauma as well as his cultural preferences, and must provide appropriate Trauma Informed Care for residents who are trauma survivors.
If a facility changes its policy to prohibit Smoking (including electronic cigarettes), it should allow current residents who smoke to continue smoking in an area that maintains the quality of life for these residents and takes into account non-smoking residents.
Facilities must have an Infection Preventionist who works physically onsite, and should determine the hours worked per week based upon a facility wide assessment. She must be certified or have specialized training in nursing, medical technology, microbiology, or epidemiology prior to beginning the job.