New Rules: CMS overhaul, must comply to participate in Medicare and Medicaid

There is big news in the overhaul for nursing home condition standards. Last month, “the Center for Medicare and Medicaid Services (CMS) published a final rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs.[i]

The Law Firm of Michael V. Favia & Associates, P.C., works with nursing home directors, administrators and staff to address regulation and compliance matters. We are happy to help nursing home health care professionals with any questions about these new rules.

The last overhaul of nursing home regulations by CMS was done in 1991 and since that time there have been significant advances in patient care and the services available in senior healthcare. The article published by JD Supra Business Advisor is worth reviewing.

Here is a list of the topics covered in the CMS final rule:

  1. Resident Abuse, Neglect and Exploitation;
  2. Admission, Transfer and Discharge Rights;
  3. Resident Assessments;
  4. Comprehensive Person-Centered Care Planning;
  5. Discharge Planning Process;
  6. Quality of Care Requirements;
  7. Quality of Life;
  8. Physician Services;
  9. Nursing Services;
  10. Behavioral Health Services;
  11. Pharmacy Services;
  12. Dental Services;
  13. Food and Nutrition Services;
  14. Facility-Wide Assessment Requirement;
  15. Binding Arbitration Agreements;
  16. Quality Assurance and Performance Improvement (QAPI);
  17. Infection Control;
  18. Compliance and Ethics Program;
  19. Physical Environment; and
  20. Training Requirements.

“CMS states that the revisions to nursing home regulations are intended to reflect the substantial advances that have been made in the theory and practice of service delivery and safety.[ii]

Nursing home administrators and educators will be busy working on how they can help everyone who works in nursing homes learn the new rules and regulations. Procedures and protocols will need to be developed to ensure nursing homes comply with the CMS rules or otherwise risk losing the privilege of participating in the Medicare and Medicaid billing programs.

About us: Michael V. Favia & Associates, P.C. is a health law and litigation firm in Chicago representing individuals, healthcare professionals and organizations with civil legal matters as well as professional licensing and regulation.

Chicago health law and litigation attorney Michael V. Favia and his associates in several locations and disciplines, advise and represent private individuals as well as healthcare professionals in all types of litigation and administrative matters involving licensing and regulatory agencies.

Michael V. Favia and Associates, P.C. represents individual physicians and health care organizations in the Chicago area with a variety of legal matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. Michael V. Favia & Associates is available at (773) 631-4580. Please visit and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You can also review endorsements and recommendations for Michael V. Favia on his profile and on LinkedIn.


[i] JD Supra Business Advisor, CMS Releases the First Comprehensive Overhaul of Nursing Home Conditions of Participation in Over 25 Years. By John Sisher II, Nov. 3, 2016.

[ii] See HNi above.