Proposed nursing home, long-term care rule moves facilities to EHRs, e-data sharing

The Centers for Medicare & Medicaid Services has once again signaled its intention to move the health industry to electronic health records, this time in its sweeping proposal to change the Conditions of Participation for nursing homes and long-term care facilities.

The proposed rule, released July 13, does not require nursing homes and long-term care facilities to adopt EHRs. However, CMS does include several provisions that contemplate the current and future use of EHRs and electronic data sharing. These include:

  • Residents would be allowed access to medical records, including in electronic format, if maintained electronically
  • Residents would be able to purchase copies of their medical records, including in electronic format if maintained electronically
  • Facilities are "encouraged" to explore how EHRs can support efforts to develop and share standardized discharge summaries
  • The rule proposes a common clinical data set to electronically share summary of care records
  • Facilities would be required to conduct annual assessments, which include an evaluation of health IT resources and electronic data sharing

Moreover, in addition to references to the interoperability roadmap and draft Interoperability Standards Advisory, which CMS has included in other recent proposed payment rules, the agency makes no bones about its plans:  

"Our revisions to this rule are intended to recognize the advent of electronic health information technology and to accommodate and support adoption of ONC certified health IT and interoperable standards," it says in the rule. "We believe that the use of such technology can effectively and efficiently help facilities and other providers improve internal care delivery practices, support the exchange of important information across care team members [including patients and caregivers] during transitions of care, and enable reporting of electronically specified clinical quality measures [eCQMs]."

CMS also recommends that facilities electronically capturing information do so using certified health IT that allows for "real time" electronic exchange with other providers.

"By utilizing certified health IT, facilities can ensure that they are transmitting interoperable data that can be used by other settings, supporting more robust care coordination and higher quality care for patients," CMS says.

The proposed changes are part of a larger overhaul of the Conditions of Participation, which also includes better coordinated care planning, required infections control and elder abuse training, even greater food and roommate choices. Comments on the rule are due in September.

To learn more:
- read the proposed rule