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What's New for Long-Term Care Facilities?

November 21, 2016

By: Courtney B. Amelung

The Centers for Medicare & Medicaid Services released a new rule that revises the requirements that long-term care facilities must fulfill in order to participate in the Medicare and Medicaid programs.  This rule, which becomes effective on November 28, 2016, is the first major update to the regulations governing long-term care providers since 1991. 

Of particular significance is the prohibition of pre-dispute arbitration agreements.  Specifically, the rule provides that long-term care facilities cannot enter into binding arbitration agreements with their residents (or their residents’ representatives) prior to the occurrence of a dispute.  After a dispute arises, the resident and the long-term care facility may voluntarily enter into a binding arbitration agreement if both parties agree and the agreement meets certain requirements.   

The rule also provides that long-term care facilities may not require a resident to sign an arbitration agreement as a condition of admission to the facility, or as a condition of the resident’s continued stay at the facility.    

However, the rule does not prohibit all arbitration agreements between residents and long-term care facilities.  Additionally, it has no effect on existing arbitration agreements and does not render them unenforceable. 

In addition to the ban on pre-dispute arbitration agreements, the new rule contains changes that are intended to improve the quality of care provided at long-term care facilities.  For example, the rule mandates that facilities provide nourishing and palatable dietary options that meet residents’ nutritional needs and preferences.  It also requires that facilities create an infection prevention and control program.  Furthermore, under the new rule, facilities must develop a comprehensive care plan for each resident within 48 hours of admission, and provide discharge planning to discharged residents and their caregivers. 

Please contact Ferrier R. Stillman or Courtney B. Amelung if you have any questions or would like additional information on the Centers for Medicare & Medicaid Services’ final rule for long-term care facilities.

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