Navigating “Safety” in Long Term Care Centers: Separating the Roles of OSHA and the CMS requirements for Emergency Preparedness

Continuation: 

In this third article regarding the connection between the Occupational Safety and Health Administration (OSHA) and the Centers for Medicare & Medicaid Services (CMS) Life Safety and Emergency Preparedness (EP) Requirements, the focus will be on how OSHA’s regulations overlap with CMS’ EP requirements, found in 42 CFR 483.73 (Appendix Z).
It’s important to note that CMS’ EP requirements do NOT apply to assisted living, however any OSHA requirements do apply.

Deadline Approaching to Submit Comments on Proposed Minimum Staffing Rule

​The formal comment period on the CMS minimum staffing proposed rule is nearing an end. Though AHCA/NCAL met its original goal of submitting 10,000 comments to CMS from members during the 60-day comment period, a new goal has been set to reach 15,000 comments to have a greater impact with CMS and the Administration.
With just under two weeks until the end of the comment period, this is a great opportunity to share with CMS why this rule won’t work. Submitting a comment is easy! Just visit our Action Center, where there are details on what to write in the comments, including specific asks for CMS regarding the rule. Comments are due November 6. Assisted living providers are encouraged to submit comments, as well.
For information on the effects of the minimum staffing proposed rule on skilled nursing, view our Issue Brief. For details on the impact of the minimum staffing proposed rule on assisted living, view our NCAL Issue Brief.
For additional information or questions, please contact Matt Smyth or Heather Posthumus​.

Proposed Minimum staffing requirements for SNFs from CMS – What You Need to Know!

Thanks to one of our alert Gero Nurse Prep students for reminding us of the importance of this pending regulation.

To get the Fast Facts on the implications of  this unfunded mandate, go here:

https://www.ahcancal.org/Advocacy/IssueBriefs/NEW%20unfunded%20staffing%20mandate_IB.pdf

AHCA/NCAL has set a goal of submitting more than 10,000 comments on this proposed rule between now and November 6th. To make your voice heard, go to:

https://www.votervoice.net/AHCA/Campaigns/103471/Respond [votervoice.net]

CMS Creates a SNF 5-Claim Probe and Educate Review Webpage

The Centers for Medicare & Medicaid Services (CMS) recently announced the start of the SNF (skilled nursing facility) 5-Claim Probe & Educate Review program. As part of the effort to lower the SNF improper payment rate, Medicare Administrative Contractors (MACs) will be reviewing a small number of claims from every Medicare-billing SNF in the country. The SNF will then be offered education to address any errors identified, helping them to avoid future claim denials and adjustments.

Find out more by going to https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Creates-a-SNF-5-Claim-Probe-and-Educate-Review-Webpage-.aspx

CMS Announces Ending of COVID Staff Vaccine Requirement, Other Protocols

Today, t​he Centers for Medicare & Medicaid Services (CMS) released a new regulatory memo QSO-23-13-ALL​ entitled “Guidance for Expiration of the COVID-19 Public Health Emergency (PHE) on May 11, 2023.” The memo outlines each waiver CMS put into place during COVID-19 and how the end of the PHE will affect those waivers. Additionally, the memo outlined timelines for certain regulatory requirements issued through the PHE. This memo applies to Long Term Care (LTC), Intermediate Care Facilities (ICF), and other provider types.
Find out more at https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Announces-Ending-of-COVID-Staff-Vaccine-Requirement,-Other-Protocols.aspx

CDC Provides New Initiative to Increase COVID-19 Vaccination in LTC Settings

​​

​​With increasing cases of respiratory disease, including COVID-19, this winter, it is imperative to encourage residents, staff, and family members to receive the updated (bivalent) COVID-19 boosters.

A recent CDC report​ showed:
  • Adults ages 65 years and older:
    • ​Continue to have the highest COVID-19-related mortality rates.
    • The COVID-19-related death rate among unvaccinated people who are 65 years and older has consistently been higher than the rate among vaccinated people.
  • Adults ages 85 years and older:
    • ​Remain at particularly high risk of dying of COVID-19.
    • The proportion of COVID-19–related deaths accounted for by adults in this age group increasing during April–September 2022 from 28% to around 40% of COVID-19–related deaths. ​

Find out more by going to https://www.ahcancal.org/News-and-Communications/Blog/Pages/CDC-Provides-New-Initiative-to-Increase-COVID-19-Vaccination-in-LTC-Settings.aspx

Listen to HealthCap’s Free Podcast Highlighting ROP3 Changes.

CMS began surveying against Phase 3 of Requirements of Participation for Nursing Homes on October 24, 2022. With 180 pages of guidance, revisions, and updates affecting 52 F-tags, many providers are feeling anxious about compliance with the new guidance.

Angie Szumlinski, Director of Risk Management for HealthCap, recently spoke with Crystal Bowens, Associate AHCA/NCAL VP of Regulatory Services, about the updates. You can hear from these in​dustry experts by listening to the free podcast here. As a reminder, AHCA/NCAL members can always reach out with their compliance questions via email at Regulatory@AHCA.org​.

CMS Releases Revisions to the Special Focus Facility Program

The Centers for Medicare & Medicaid Services (CMS) has released a revised Special Focus Facility (SFF) Program policy memo QS0-23-01-NH and updated the monthly SFF posting​. These revisions are meant to increase the requirements for completion of the program and enforcement for facilities that do not demonstrate improvement.

Read more at https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Releases-Revisions-to-the-Special-Focus-Facility-Program.aspx

CMS Releases Revised Guidance on Vaccine Mandate IFR

CMS has released revised interpretive guidance for the COVID-19 vaccine mandate interim final rule (IFR). Three memoranda have been updated, including QSO-22-07-ALL-Revised, QSO-22-09-ALL-Revised, and QSO-22-11-ALL-Revised.
The revisions were made to clarify the expectations for assessing compliance with the requirement to ensure all staff are vaccinated. AHCA/NCAL has highlighted key revisions below, but providers are encouraged to review the Long-Term Care and Skilled Nursing Facility Attachment A-Revised, as well as the applicable memo listed above, for detailed changes.