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Reform of Requirements for Long-Term Care Facilities

Implementation Timeframes

**Note: These final regulations will be effective 60 days following the date of public inspection of this final rule in the Federal Register. **

Phase 1: Upon the effective date of the final rule (November 28, 2016).

Phase 2: 1 year following the effective date of the final rule (November 28, 2017).

Phase 3: 3 years following the effective date of the final rule (November 28, 2019).

 

Regulatory Section

Implementation Deadline

§ 483.1 – Basis and scope

§ 483.5 – Definitions

§ 483.10 – Resident rights

§ 483.12 – Freedom from abuse, neglect, and exploitation

§ 483.15 – Admission, transfer, and discharge rights

§ 483.20 – Resident assessment

§ 483.21 – Comprehensive person-centered care planning

§ 483.24 – Quality of life

§ 483.25 – Quality of care

§ 483.30 – Physician services

§ 483.35 – Nursing services

§ 483.40 – Behavioral health services

§ 483.45 – Pharmacy services

§ 483.50 – Laboratory, radiology, and other diagnostic services

§ 483.55 – Dental services

§ 483.60 – Food and nutrition services

§ 483.65 – Specialized rehabilitative services

§ 483.70 – Administration

§ 483.75 – Quality assurance and performance improvement

§ 483.80 – Infection control

§ 483.85 – Compliance and ethics program

§ 483.90 – Physical environment

§ 483.95 – Training requirements

This entire section will be implemented in Phase 1.

This entire section will be implemented in Phase 1.

The section will be implemented in Phase 1 with the following exception: • (g)(4)(ii) -(v) Providing contact information for State and local advocacy organizations, Medicare and Medicaid eligibility information, Aging and Disability Resources Center and Medicaid Fraud Control Unit—Implemented in Phase 2.

This section will be implemented in Phase 1 with the following exceptions: • (b)(4) Coordination with QAPI Plan—Implemented in Phase 3. • (b)(5) Reporting crimes/1150B—Implemented in Phase 2

This section will be implemented in Phase 1 with the following exceptions: • (c)(2) Transfer/Discharge Documentation—Implemented in Phase 2.

This entire section will be implemented in Phase 1.

This section will be implemented in Phase 1 with the following exceptions: • (a) Baseline care plan—Implemented in Phase 2. • (b)(3)(iii) Trauma informed care—Implemented in Phase 3.

This entire section will be implemented in Phase 1.

This section will be implemented in Phase 1 with the following exception: • (m) Trauma-informed care—Implemented in Phase 3.

This entire section will be implemented in Phase 1.

This section will be implemented in Phase 1 with the following exception: • Specific usage of the Facility Assessment at § 483.70(e) in the determination of sufficient number and competencies for staff—Implemented in Phase 2.

This section will be implemented in Phase 2 with the following exceptions: • (a)(1) As related to residents with a history of trauma and/or post-traumatic stress disorder—Implemented in Phase 3. • (b)(1), (b)(2), and (d) Comprehensive assessment and medically related social services—Implemented in Phase 1.

This section will be implemented in Phase 1 with the following exceptions: • (c)(2) Medical chart review—Implemented in Phase 2. • (e) Psychotropic drugs—Implemented in Phase 2.

This entire section will be implemented in Phase 1.

This section will be implemented in Phase 1 with the following exceptions: • (a)(3) and (a)(5) Loss or damage of dentures and policy for referral—Implemented in Phase 2. • (b)(3) and (b)(4) Referral for dental services regarding loss or damaged dentures—Implemented in Phase 2.

This section will be implemented in Phase 1 with the following exceptions: • (a) As linked to Facility Assessment at § 483.70(e)—Implemented in Phase 2. • (a)(1)(iv) Dietitians hired or contracted with prior to effective date—Built in implementation date of 5 years following effective date of the final rule. • (a)(2)(i) Director of food & nutrition services designated to serve prior to effective—Built in implementation date of 5 years following the effective date of the final rule. • (a)(2)(i) Dietitians designated to after the effective date—Built in implementation date of 1 year following the effective date of the final rule.

This entire section will be implemented in Phase 1.

This section will be implemented in Phase 1 with the following exceptions: • (d)(3) Governing body responsibility of QAPI program—Implemented in Phase 3. • (e) Facility assessment—Implemented in Phase 2.

This section will be implemented in Phase 3 with the following exceptions: • (a)(2) Initial QAPI Plan must be provided to State Agency Surveyor at annual survey—Implemented in Phase 2. • (g)(1) QAA committee—All requirements of this section will be implemented in Phase 1 with the exception of subparagraph (iv), the addition of the ICPO, which will be implemented in Phase 3. • (h) Disclosure of information—Implemented in Phase 1. • (i) Sanctions—Implemented in Phase 1.

This section will be implemented in Phase 1 with the following exceptions: • (a) As linked to Facility Assessment at § 483.70(e)—Implemented in Phase 2. • (a)(3) Antibiotic stewardship—Implemented in Phase 2. • (b) Infection preventionist (IP)—Implemented in Phase 3. • (c) IP participation on QAA committee—Implemented in Phase 3.

This entire section will be implemented in Phase 3.

This section will be implemented in Phase 1 with the following exceptions: • (f)(1) Call system from each resident’s bedside—Implemented in Phase 3. • (h)(5) Policies regarding smoking—Implemented in Phase 2.

This entire section will be implemented in Phase 3 with the following exceptions: Abuse, neglect, and exploitation training—Implemented in Phase 1. • (g)(1) Regarding in-service training, (g)(2) dementia management & abuse prevention training, (g)(4) care of the cognitively impaired—Implemented in Phase 1. • (h) Training of feeding assistants—Implemented in Phase 1.

 

 

Document Details

Printed version:
PDF (Click Here)
Publication Date:
10/04/2016 (/documents/2016/10/04)
Agencies:
Centers for Medicare & Medicaid Services (Click Here)
Effective Date:
11/28/2016
Document Type:
Rule
Document Citation:
81 FR 68688
Page:
68688-68872 (185 pages)
CFR:
42 CFR 405
42 CFR 431
42 CFR 447
42 CFR 482
42 CFR 483
42 CFR 485
42 CFR 488
42 CFR 489
Agency/Docket Number:
CMS-3260-F
RIN:
0938-AR61 (Click Here)
Document Number:
2016-23503

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