New CMS rules may add assurances for long-term care planning

In Texas and all other states, long-term care facilities have to comply with regulations imposed by Medicare and Medicaid if the facilities want to participate in those government programs. Recently, those agencies have proposed new rules for long-term care institutions. The new rules will not have a direct impact on one's long-term care planning, but the quality and effectiveness of care in those facilities will be substantially improved by the changes.

The Centers for Medicare and Medicaid Services (CMS) plans various changes in the areas of safety, professional standards, and other issues related to improving the quality and efficiency of care. CMS estimates the implementation of the rule will cost $729.5 million in the first year. One of the main goals of the rules is to bring about  "person-centered" care.  

The changes include requiring detailed information to be provided to the new facility when a patient is transferred. Additionally, facilities will be required to develop a baseline care plan for each resident that must include instructions for care. The team that develops the care plans will include a nurse aide, a social worker and a nutrition services staff member.

There will be a Preadmission Screening and Resident Review procedure to identify any specialized services for the resident. Additionally, facilities will be required to include discharge planning summaries containing a reconciliation of all medications and a post-discharge plan of care. There are numerous other rules to improve medical staff decision making with respect to transfers to hospitals and other services. A data-driven quality care program will be required of each institution.

Residents of Texas will be assured a better quality and efficiency of care once these changes are put into full operational effect. Long-term care planning will not be directly impacted, but some decisions may be easier for individuals and families with the knowledge that certain protections do exist. The prospective changes seem to be reasonably designed to improve a resident's experience and expectations with respect to long-term care facilities.  

Source:, "CMS proposes individualized care plan for long-term care patients", Nicole Stempak, Sept. 23, 2015

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