AHA asks for changes in new rules for long-term care facilities

The American Hospital Association (AHA) has suggested changes to the requirements for the operation of long-term care facilities (LTCs) in a letter to the Centers for Medicare & Medicaid Services (CMS), saying such changes would cost the sector far more than CMS has estimated.

The changes include a quality assessment performance improvement initiative; improved infection prevention and control; expanded rights of LTC patients; expansion of which medical professionals can provide orders regarding a patient's immediate care and needs after admission; and tightened guidelines governing discharges and transitions of care post-discharge.

The U.S. Department made a sweeping list earlier this year of rules for improving care at the 15,000 long-term care facilities that operate in the United States. The rules were published in the Federal Register over the summer, but they are still being debated by the provider community prior to their final adoption.

The changes are seen as especially important given that in the coming years nursing homes and long-term facilities will likely serve as the main focus of care for an aging American population.

The agency's estimate that the changes would cost $700 million during their first year of implementation was "significantly" short of what it believes are the actual costs, according to the 13-page letter, authored by AHA Executive Vice President Tom Nickels and addressed to CMS Acting Director Andrew Slavitt.

"Although CMS estimates a first-year per facility cost of $46,491 to implement all changes in the proposed rule, our members have indicated that the proposed addition of an antibiotic stewardship program and other pharmacy requirements would cost that much alone," the letter said. Other physical requirements including each patient bathroom requiring a shower was also questioned regarding costs; the AHA asked whether a Jack-and-Jill arrangement would suffice.

To learn more:
- read the AHA's letter (.pdf)