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Skilled Nursing Facility and Hospice Contracts – Prime Time to Update

Effective November 28, 2016, the Centers for Medicare and Medicaid Services published a final rule which revised the Medicare Conditions of Participation for Long-Term Care Facilities. There are three different phases of implementation.

The regulations included in Phase 1 had to be implemented by November 28, 2016. The Phase 2 regulations had to be implemented by November 28, 2017. The Phase 3 regulations must be implemented by November 28, 2019.

The Phase 3 regulations include entirely new sections that must be implemented, such as the compliance and ethics program requirement of 42 CFR § 483.85. The Phase 3 regulations also require a call system from each resident’s bedside.  In order to comply with the Phase 3 regulations, skilled nursing facilities and hospices may need to update their contracts. Reviewing the contracts not only helps each facility ensure compliance and financial stability; it also helps allocate responsibility for any required updates or changes.

Additionally, the Michigan Department of Licensing and Regulatory Affairs (“LARA”) is in the process of updating the administrative rules for Licensing Health Facilities and Agencies. The proposed rules are condensed into one rule set with parts that apply to all types of providers and one part with provider-specific requirements. They will likely go into effect in the spring of 2019. Here is a link to our blog post regarding these proposed new rules.

In light of the changes to the Medicare Conditions of Participation for Long-Term Care Facilities, and the changing administrative rules, facilities with reimbursement contracts in place can benefit from having their service agreements analyzed. This will ensure that facilities will be in compliance with the new requirements. 

If you have any questions about how the new regulations might affect your facility, please contact one of our health care attorneys.

Categories: Contracts, Hospice, Hospitals, Medicare/Medicaid

 has particular expertise in health law and she represents providers with emphasis in the areas of physicians, hospice, home care and long term care, including one of the country’s largest long-term care organizations. She has a vast array of experience in teaming with providers in the areas of regulatory compliance and contracts. 

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