STAFFING

Nursing homes qualifying for exemptions is going to be tough

Nursing home staffing exemptions are going to be tough to obtain, as it’s unclear how to prove some aspects of the criteria.

Facilities will need to meet four criteria for an exemption, but it’s unclear how operators will prove some aspects of the criteria to the Centers for Medicare & Medicaid Services (CMS), according to Leah Klusch, executive director for the Alliance Training Center.

The four exemption criteria are:

1. proving workforce is unavailable (or the facility is at least 20 miles from another long-term care facility);
2. the facility is making a good faith effort to hire and retain staff;
3. the facility provides documentation of its financial commitment to staffing; and,
4. the facility has not failed to submit PBJ data.

Operators would need to meet all four criteria to qualify.

STAFFING MANDATE

AHCA/NCAL and National Association of Licensed Practical Nurses lead joint comment letter requesting CMS withdraw Federal Staffing Mandate

The one-size-fits-all mandate proposes that nursing homes provide residents with a minimum number of hours of care from a registered nurse (RN) and from a nurse aide per day, but excludes LPNs who are critical members of the care team. LPNs make up 13 percent of the nursing home workforce, with more than 170,000 working in nursing homes today. The groups ask CMS to withdraw the rule altogether, highlighting how the exclusion of LPNs is yet another example of its fundamental flaws.

The letter states in part, “We are requesting the Administration to withdraw this archaic, unfunded healthcare policy and instead focus on meaningful, supportive ways to grow and retain the nursing home workforce.”

The proposed CMS rule is unfounded in its approach, as the agency’s own commissioned study found that no level of staffing guarantees quality care. Further, a recent analysis found that the federal staffing rule threatens the displacement of nearly 300,000 residents.

ASSISTED LIVING

Regulatory issues in assisted living

There are over 30,000 assisted living communities in the United States which provide residents with assistance in activities of daily living, housekeeping, meals, medication management,  and wellness programs.  Some also provide Alzheimer’s/dementia care.  While assisted living facilities do not provide 24-hour skilled nursing services, they do typically coordinate with other care providers, which requires integration of medical record documentation.

LaShuan Bethea, Executive Director of the National Center for Assisted Living (NCAL), provided an overview of recent assisted living regulatory changes at the DRI Senior Living and Long-Term Care Litigation Seminar.

ASSISTED LIVING

Strategic Documentation