Latest Insights and Updates

The Centers for Medicare & Medicaid Services (CMS) has released a final rule outlining staffing requirements for nursing homes, including a minimum of 3.48 hours of direct daily care per patient. The rule also requires registered nurses to be on-site 24 hours a day, seven days a week, but allows for exemptions in certain circumstances.

The CMS announced that it will exempt nursing homes from having registered nurse coverage for up to eight hours out of 24 hours a day "under certain circumstances." Additionally, the director of nursing can count toward the rule's 24/7 RN requirement. The agency stated that this ensures an RN is available to help mitigate preventable safety events.

The White House announced that the final rule would increase direct daily care per patient from a proposed 3.0 hours to 3.48 hours, with 3.0 of those hours being provided by licensed nurses and nurse aides. The remaining 0.48 hours can be provided by other caregivers. The CMS also established criteria for facilities seeking exemptions from the total nurse staffing requirement, including a minimum combined licensed nurse and nurse aide-to-population ratio in their area that is at least 20% below the national average.

The implementation of the rule will be staggered, with rural facilities having up to five years to meet the last of the requirements, while non-rural providers have three years. Facilities can also apply for exemptions if they demonstrate "good faith efforts" to hire and retain staff, such as through job postings and competitive wage offerings.

The announcement has received mixed reactions from the long-term care industry, with some criticizing the timing and the potential impact on facilities already struggling to recruit and retain staff.

This article was originally found on mcknights.com

The Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would stabilize the process of selecting, retaining, and removing measures in the Value-Based Purchasing (VBP) program for skilled nursing facilities (SNFs). The proposed rule includes eight specific factors that CMS would consider when determining whether a measure should be removed or replaced. These factors include uniformly good performance across a measure, signaling that "meaningful distinctions and improvements in performance can no longer be made"; and whether improvement on a given measure is helping resident outcomes.

The proposed rule also states that once a measure is adopted for the VBP program, it would automatically be retained for all subsequent years unless CMS specifically proposes to remove or replace it. This policy would mean that CMS would not have to continuously propose a measure for inclusion year after year.

Industry experts welcome this proposal as it brings stability to the process and allows SNFs to focus on improving quality without worrying about changes in measures every year. However, there may be some critics of specific measures, but overall, the proposal is seen as a positive step forward.

The proposed rule also mentions that CMS is considering adding new measures related to interoperability, health equity, and social determinants of health. Additionally, CMS is assessing several resident experience measures and considering whether a composite staffing measure is feasible, which would combine the two separate staffing measures in the current set.

Public comments on the proposed rule are being gathered through May 28.

This article was originally found on skillednursingnews.com

1. Senators urge CMS to withhold staffing mandate: A group of senators has written to the Centers for Medicare and Medicaid Services (CMS) requesting that they withhold a proposed rule requiring minimum staffing levels in skilled nursing facilities. The senators argue that this requirement would have unintended consequences, including reducing access to care for veterans.
2. OIG estimates 1 in 4 for-profit nursing homes not complying with infection control staffing rules: According to the Office of Inspector General (OIG), approximately one-quarter of for-profit nursing homes are not adhering to regulations regarding infection control staffing.
3. Updated COVID shots from Pfizer, Moderna cleared by FDA: The US Food and Drug Administration (FDA) has approved updated versions of COVID-19 vaccines developed by Pfizer and Moderna.
4. CMS has received 12K complaints of No Surprises noncompliance; won $1.7M in restitution: The Centers for Medicare and Medicaid Services (CMS) has reported receiving over 12,000 complaints regarding non-compliance with the No Surprises Act. As a result, CMS has secured approximately $1.7 million in restitution.
5. New Jersey to erase $100M of medical debt: New Jersey Governor Phil Murphy announced that the state will eliminate around $100 million worth of medical debt for approximately 85,000 residents.

This article was originally found on healthcaredive.com

The Centers for Disease Control and Prevention (CDC) has released a report on SARS-CoV-2 infections among maintenance dialysis patients in the United States during the Delta and early Omicron waves. The report provides an overview of the data collected, methodology, and results.

Here are some key points from the report:

• The study analyzed data from June 30, 2021, to September 27, 2022, which covers the Delta and early Omicron waves.
• The study included maintenance dialysis patients who were vaccinated with either a primary or booster dose of COVID-19 vaccine.
• The results showed that SARS-CoV-2 infection rates decreased over time among vaccinated patients, but increased among unvaccinated patients.
• The report highlights the importance of vaccination in preventing SARS-CoV-2 infections and severe illness among maintenance dialysis patients.
• The study also found that COVID-19-related deaths were more common among older adults (≥ 75 years) and those with underlying health conditions.

The report includes several figures, including:

• Figure 1: SARS-CoV-2 infections per 10,000 patient-weeks among maintenance dialysis patients by primary and booster dose vaccination status.
• Figure 2: Age-stratified population-based SARS-CoV-2 incidence and COVID-19-related death rates among the overall U.S. population and maintenance dialysis patients.

The report concludes that vaccination is an effective way to prevent SARS-CoV-2 infections and severe illness among maintenance dialysis patients, particularly those with underlying health conditions.

This article was originally found on cdc.gov