CMS Issues Updated Guidance Intended to Improve Quality of Nursing Home Care

Today, more than 1.4 million individuals live in Medicare- and Medicaid-certified nursing homes across the United States. As part of an effort seeking to improve the health and safety of nursing home residents nationwide, the Centers for Medicare and Medicaid Services (CMS) released updated guidance in June for the state agencies that are responsible for surveying long-term care facilities and investigating complaints.

The wide range of updates include the following:

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• Nursing homes must provide data on their staffing, which the CMS will use in a research study aimed in part at establishing minimum staffing level requirements for these facilities.
• LTC facilities will be required to employ at least one part-time, on-site infection preventionist who meets the needs of the facility and oversees an effective infection prevention and control program.
• Nursing home surveyors across states will need to investigate complaints and reports of abuse in a timely and consistent manner. A 2019 Government Accountability Office report had previously found that information on abuse was not readily available and that the processes through which incidents of abuse were reported to law enforcement varied widely by state.
• The revisions provide clarifications on various requirements related to nursing homes’ discharge of residents, compliance with arbitration agreements, and the procedures they follow to manage complaints and report incidents.
• Updated mental health guidance targets the inappropriate use of unnecessary medications, such as antipsychotics.
• The CMS also outlines recommendations for nursing homes on limiting occupancy per room to two individuals to help prevent infection while also offering an enhanced level of comfort and privacy for residents. It also urges operators to allow for a greater number of single-occupancy rooms.

Nursing home surveyors will begin to apply the new guidelines in October 2022.