In 2019, the Centers for Medicare and Medicaid Services (CMS) proposed a burden reduction rule entitled Medicare and Medicaid Program; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency. This rule proposed changes to significant sections of the Requirements of Participation (RoPs), including phase 3 sections on Infection Preventionist hours and the Compliance and Ethics program. Had the rule been finalized, impacted sections of RoPs phase 3 would have been delayed. However, the rule was not finalized, creating a great deal of confusion. In November 2019, RoPs 3 was implemented as written and the proposed burden reduction rule was essentially meaningless as far as nursing home operations and compliance was concerned. 

Several months ago, LeadingAge inquired about the status of this proposed rule and CMS confirmed that it was required to respond to the rule in some way. The deadline for response would have been July 18, 2022. This week, CMS filed an extension in the Federal Register that delays the deadline for response to this rule to July 2023.

At this time, all nursing homes must continue to comply with the Requirements of Participation as written. With CMS’s recent release of the long-awaited surveyor’s interpretive guidance, more information is now available to assist nursing homes in implementing requirements. The proposed burden reduction rule continues to have no impact on current operations. CMS states that they are reviewing the provisions of the proposed rule and comments received in 2019 to determine how to proceed. While we expect to see a finalized rule prior to the July 2023 deadline, a finalized rule may not include the changes as proposed. LeadingAge will keep members updated as this situation developments, including alerting members to any additional comment periods or the issuance of a final rule.