It’s been over a quarter of a century since the Centers for Medicare and Medicaid (CMS) gave a major scrub down to the requirements governing Long Term Care (LTC) facilities.
This past October marked the end of a 5-month comment period of a major rewrite. The rewrite solicited 9,800 comments from the LTC industry.
Some of what we can expect from the rewrite focuses on increasing quality care and safety for LTC residents. Workforce improvements such as new training requirements and staffing considerations will be based on the acuity and diagnoses and not simply the number of residents. Other changes include efforts to reduce infections and the use of anti-psychotic medications.
CMS believes the changes will bring about better care for residents – promoting person centered care, improved care and discharge planning.
CMS also claims the revisions are good for physicians. According to the proposed revision, a patient needing to go to the hospital as an unscheduled visit must have an in person evaluation conducted by a physician, physician assistant or, nurse practitioner.
While this move will serve in a continued effort to reduce unnecessary readmissions, it may become a point of concern for physicians and LTC facilities. CMS research shows 45% of hospitalizations among Medicare and Medicaid enrollees could have been avoided.
Dr. Todd Grendon, Board Certified Geriatrician, Vice Chairman of Internal Medicine and Section Chief of Geriatric Medicine at St. Joseph Hospital commented on the reforms, “With the push to get patients out of the hospital quicker and more efficiently and the increasing capability of nursing homes, by the very nature of that construct there are going to be sick patients that need to be sent to the hospital urgently.”
However, Grendon is optimistic about the future for LTCs. “These are good trends as we enter into an era in which hospitals and physicians and LTCs are receiving incentives to work together and be aligned so that the quality of care of residents improve.”
CMS believes the new rule may better allow physician assistants, nurse practitioners and clinical nurse specialists to practice to the full extent of their license.
Grendon added, “We have an aging population with lots of medical needs. In order to meet those needs, we need to be innovative and create an environment that also fosters physicians and healthcare practitioners.”
CMS has three years from the date of introduction to approve the rewrite. However, in an email from CMS, they reported they intend to implement sooner. Dr. Todd Grendon is also the Associate Medical Director of the Selfhelp Home.