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Long-Term Care Providers Face New CMS Participation Requirements

Most long-term care providers are aware of the new participation rule issued by the Centers for Medicare & Medicaid Services (CMS) and that the current deadline for Phase 2 compliance with this rule is set for November 28, 2017. Nonetheless, many in the industry are continuing to push for additional time. The main components of the new rule are admission, visitation, and grievance policies.

In terms of admissions policies, long-term care facilities must focus on getting a more extensive social history at the time of admission. For instance, facilities must be aware of whether newly admitted residents have any substance abuse issues. Even if the resident doesn’t tell the truth, there must be extensive records indicating that facility employees tried to get as much truthful information as possible.

While CMS previously pushed for a 24/7 visitation policy, the new rule relaxes this requirement to some degree. Visitation access around the clock, according to providers, creates several different problems, including adequate staffing and measures to handle the visits of dysfunctional family members. For example, one provider cited the problems caused by a family member visiting a resident at 2:00 a.m. who repeatedly turned on the television and disturbed the resident’s roommate. Family members who visit at all hours without proper supervision also can endanger residents, such as by providing them with cigarettes while they are on oxygen, offering food that the resident is unable to swallow, or adjusting tube feedings or medications.

Grievance policies also are a major focus of the new CMS rule. The goal is to have a people-oriented person in charge of any grievances, who can keep meticulous records of complaints and decisions. The person in charge of grievances also should be wary of how complaints are described and/or worded; failing to do so can lead to a cause of action against the facility.

Abusive actions toward residents of nursing homes or community based residential facilities sometimes can result in significant injuries. What’s worse is that many of these abuse incidents are wholly preventable. The Wisconsin long-term care abuse lawyers of Boller & Vaughan know how to protect your loved ones’ rights. Our law firm handles these types of personal injury cases on a regular basis and is experienced in advocating on behalf of clients just like you. We are here to help you fight back against the healthcare facility that caused harm to your loved one, and to get any compensation to which you are entitled.