Subacute-care units provide a specialized level of care to medically fragile patients. Subacute patients are individuals who do not need acute care, but who are too ill to be cared for by most skilled-nursing facilities. Frequently, these individuals are ventilator-dependent or require frequent respiratory treatments. While subacute beds are licensed as skilled-nursing beds, they are reimbursed differently and are subject to additional staffing and patient criteria requirements.
CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective subacute-care services.
The Centers for Medicare & Medicaid Services (CMS) has issued to state survey agency directors information regarding CPR in nursing homes. CMS Survey & Certification memo 14-01-NH disallows nursing home policies that prohibit employees from administering CPR to residents. Effective Oct. 18, nursing facilities must provide basic life support to a resident who experiences cardiac arrest, in accordance with that resident’s advance directives or a do-not-resuscitate order. CPR-certified staff must be available at all times and must administer CPR prior to the arrival of emergency medical personnel. A copy of the memo is attached.
The California Department of Public Health has issued an All Facilities Letter (AFL) concerning Minimum Data Set 3.0 discharge assessments that have not been completed and/or submitted. The AFL provides information about recent communication from the Centers for Medicare & Medicaid Services, which is providing an opportunity for facilities to rectify any missing and/or incomplete discharge assessments. Beginning Oct. 1, 2013, MDS assessments older than three years will not be accepted. For more information, see the attached AFL.
The California Department of Public Health (CDPH) has issued a reminder to skilled-nursing facilities (SNF) that optional services provided must be approved by the Licensing and Certification (L&C) program. SNFs must post a copy of the facility’s license, including a list of its optional services, in a location accessible for public view. Optional services are units within the SNF that provide specific types of care such as physical therapy, occupational therapy, speech pathology, audiology, social work services and special treatment program services. See the attached All Facilities Letter for more information on special approvals and requirements that must be met whenever a SNF adds, deletes or modifies an optional service.
The California Department of Public Health (CDPH) has issued a reminder that the California Minimum Data Set newsletters (California MDS Nuggets) are posted on the CDPH website. The MDS is a powerful tool offered by the Centers for Medicare & Medicaid Services (CMS) for implementing standardized assessment and for facilitating care management in nursing homes and non-critical access hospital swing-beds. The MDS 3.0 has been designed to improve the tool’s reliability, accuracy and usefulness, and to expand resident input during the assessment process. Visit the CDPH website to access other California MDS 3.0 information at www.cdph.ca.gov/programs/LnC/Pages/MDS.aspx. For more information on the MDS newsletters, see the attached All Facilities Letter.
Under a final rule recently issued by the Centers for Medicare & Medicaid Services (CMS), skilled-nursing and other long-term care facilities that provide hospice care through a Medicare-certified hospice provider must have a written agreement with the hospice specifying the roles and responsibilities of each entity. The goal of the rule is to improve the quality and consistency of hospice care for long-term care residents, and to reduce duplication by increasing care coordination and communication between the two types of providers. A copy of the rule is attached.
The Centers for Medicare & Medicaid Services (CMS) has issued a reminder to state survey agencies about access and visitation rights for residents for long-term care facilities (LTCs), including skilled-nursing facilities. The CMS memorandum reviews current interpretive guidelines that require that all individuals seeking to visit a resident be given full and equal visitation privileges, based on resident preference and within reasonable restrictions for resident safety. Residents must be notified of their rights to have visitors on a 24-hour basis, including but not limited to spouses (including same-sex spouses), domestic partners (including same-sex domestic partners), other family members and friends.