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New Information Released by CMS: Revised Interpretive Guidelines, New F-Tags and More!

July 06, 2017

The Centers for Medicare and Medicaid Services (CMS) issued a Survey & Certification Memo announcing the release of several new documents related to the revised federal nursing home regulations, and information about the new survey process and training resources. In the memo, CMS also revealed it will impose a one-year restriction of enforcement remedies for specific Phase 2 requirements and hold constant for one year the Nursing Home Compare health inspection rating for any surveys conducted after November 28, 2017.

Consumer Voice will provide advocates with more information about the Interpretive Guidelines once we have completed our review and analysis. Additional information about the new survey process will be coming as well.

Below is a summary of the Survey & Certification Memo:

Revised Interpretive Guidelines. These are contained in Revised State Operations Manual (SOM) Appendix PP.  The guidelines are effective November 28, 2017.  They include clarification to existing unchanged requirements, guidance for new requirements implemented in Phase 1, as well as guidance for the new Phase 2 regulations. CMS notes that it has added a section in some areas to the Interpretive Guidance titled “Key Elements of Noncompliance.” This is intended to provide guidance about the key behaviors and practices identified in the regulation.  Note that Appendix PP uses newly designated F-Tags (see below).

A Crosswalk of Old F-Tags to New F-Tags.  Since the regulatory sections in the revised rules were re-structured, CMS renumbered the F-Tags. Some tags were combined, and some tags were split into multiple subparts.  These new F-Tags will be used after November 28, 2017.  The crosswalk shows you old F-Tags and the corresponding new F-Tag(s).

Survey Process. CMS is launching a new, computer-based Long Term Care survey system at the same time that Phase 2 is implemented. Information about the survey process is available here, which includes a slide deck outlining the survey process.

Training Resources. CMS is providing several training resources on its website and on an MLN Connect call on July 25, 2017 from 1:30 to 3:00pm EST.

Enforcement and Nursing Home Compare Considerations.  CMS states that to address concerns related to the scope and timing of the changes, it will provide limited enforcement remedies for certain Phase 2 provisions and will be holding constant the Nursing Home Compare health inspection rating for one year.

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