Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare

On September 28, 2016, CMS revised the skilled nursing facility (SNF) and nursing facility (NF) Requirements for Participation, which became effective on November 28, 2016, and have a three-part phase-in of implementation dates over three years. Phase 1 became effective on November 28, 2016. Implementation of the new regulations for nursing homes under Phase 2 become effective on November 28, 2017.

To address concerns about the implementation of the new requirements and new long term care survey process, CMS will be making specific policy and process adjustments to the enforcement system and results posted on Nursing Home Compare. These changes include:

  • Temporary moratorium on imposing certain enforcement remedies for specific Phase 2 requirements : CMS will provide an 18 month moratorium on the imposition of certain enforcement remedies for specific Phase 2 requirements. This 18 month period will be used to educate facilities about specific new Phase 2 standards.
  • Freeze Health Inspection Star Ratings: Following the implementation of the new long term care survey process on November 28, 2017, CMS will hold constant the current health inspection star ratings on the Nursing Home Compare website for any surveys occurring between November 28, 2017 and November 27, 2018.
  • Availability of Survey Findings: The survey findings of facilities surveyed under the new long term care survey process will be published on Nursing Home Compare but will not be incorporated into calculations for the Five-Star Quality Rating System for 12 months. CMS will add indicators to Nursing Home Compare that summarize survey findings.
  • Methodological Changes and Changes in Nursing Home Compare: In early 2018, Nursing Home Compare health inspection star ratings will be based on the two most recent cycles of findings for standard health inspection surveys and the two most recent years of complaint inspections.

Additional information is available: S&C: 18-04-NH – Temporary Enforcement Delays for Certain Phase 2 F-Tags and Changes to Nursing Home Compare.

Preparation for Launch of New Long-Term Care Survey Process

Beginning November 28, 2017, the Centers for Medicare & Medicaid Services (CMS) is launching the new long term care survey process. The long term care survey process will be implemented by each state for all long term care standard surveys and reflects CMS efforts to create an effective and efficient survey process that combines the best of both the Traditional and Quality Indicator Survey (QIS) processes into a single nationwide survey process. The long term care survey process includes the following:

  • The new computer-based long term care survey process will be effective November 28, 2017.
  • Appendix P will no longer be available: Beginning with surveys occurring on November 28, 2017, Appendix P will no longer be accessible. The long term care survey process procedure guide will replace Appendix P as the procedural and technical guide for conducting long term care standard surveys. Chapter 7 of the State Operations Manual (SOM) will be revised to include survey policy.
  • Survey Resources: A link to resources surveyors will need to conduct long term care surveys will be made available on November 17, 2017.

CMS has identified survey policy-related information which surveyors will need to conduct surveys and has incorporated it into the survey software, the long term care survey process procedure guide, or created a separate document. This information is available at Survey Resources.

Additional information is available: S&C: 18-05-NH – Preparation for Launch of New Long-Term Care Survey Process (LTCSP).

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