The Centers for Medicare & Medicaid Services ("CMS") recently announced that they will delay enforcement penalties related to Phase 2 of their revised nursing home Requirements for Participation (commonly referred to in the industry as the "Mega Rule").
The Mega Rule includes significant changes to the existing nursing home Requirements for Participation. CMS issued the Mega Rule on September 28, 2016 with three implementation phases. Phase 1 became effective on November 28, 2016. Phases 2 and 3 will become effective on November 28, 2017 and November 28, 2019, respectively. CMS announced that it would delay for one year the use of enforcement remedies (including civil monetary penalties, denial of payment, and termination or Medicare and/or Medicaid participation) for certain Phase 2 requirements.
While the one-year enforcement delay is good news for providers, it isn’t time for complacency when it comes to compliance. CMS noted that the one-year delay in enforcement is not a change in the required Phase 2 implementation date. If a facility is found to be out of compliance with Phase 2 requirements beginning on November 28, 2017, CMS may require the facility to undergo a directed plan of correction or additional directed in-service training.
CMS announced that the delay was issued in response to providers' concerns regarding the scope and timing of the Phase 2 requirements. The Phase 2 requirements include, for example, the development of an antibiotic stewardship program to combat multi-drug resistant organisms, as well as new requirements for medical chart review and psychotropic drugs.
In the same announcement, CMS stated that it will be holding constant the Nursing Home Compare health inspection rating for one year for any surveys conducted after November 28, 2017. This will ensure that facilities are being rated based on the same standards. CMS also released with its announcement (1) updated guidance for Appendix PP in the State Operations Manual; and (2) a revised list of F-Tags with a crosswalk of old tags to new tags. CMS will also provide on its website training materials for nursing facilities regarding these new requirements.