Part 1: Support and Opposition of CMS Imminent Rule
The Centre for Medicare and Medicaid Services (CMC) released a proposed rule document highlighting measures aimed at improving the long-term care systems. The proposed rule focuses on reducing excessive hospital readmissions and infections, improving the quality of care, and implementing new safety procedures. This move counts as one of the first major refurbishments of the Medicaid governed care systems since the establishment of the rules that presently accommodate over 70% of the total Medicaid enrollees (Haskins, 2015). Some Stakeholders have commended CMC efforts to improve the efficiency and effectiveness the long-term care systems. However, benefits of the proposed rule notwithstanding, other stakeholders have shown their concern over the costs and resources needed to apply changes suggested by CMC.
Among the stakeholders supporting the proposed changes, Consumer Union released a statement commending the department’s proposal. The Consumer Union indicated that they support CMS’s proposal to strengthen and clarify the standards and protection offered to residents in nursing homes and long-term care establishments (Haskins, 2015). American Association of Retired Persons (AARP) applauded CMC’s efforts to enhance protection of beneficiaries. AARP supported the rule to prohibit facilities from hiring individuals based on their experience of abuse, neglect or mistreatment. AARP also believes that the proposed rule considerably betters discharge planning by covering a broad scope of people that would require a release plan (Dickson, 2015).
American Health Care Association (ACHA) opposed to the CMC proposed changes noted that the modification of the conditions of participation for long-term care facilities required some necessary changes (Dickson, 2015). However, ACHA expressed concern that the CMC rule proposed a comprehensive change of magnitude the government has never before pursued in the lifetime of both Medicare and Medicaid. ACHA stated that the costs implied by the changes would be a huge burden for the nursing homes (Stein, 2015). Leading Age opinion on the proposed rule was that the rules’ proposal for a complete change in the current participation requirements if implemented would require an extended timeframe for transition and training. The American Psychiatric Association opposed a stipulation in the proposed rules that would impose strict measures for evaluation and discontinuation of certain medication for some individuals (Dickson, 2015). The association criticized the rule’s lack of clarity in highlighting the benefits of discontinuation or indicating how restricting use is best or essential for some patients.
Part 2: Personal Opinion on CMS Rule
The CMC proposal to change the long-term care of individuals has in effect led to significant changes in the practice since the development of the current requirements. I agree that comprehensive review and updating are necessary so that the practice reflects the current professional standards. However, my support notwithstanding, I am concerned that the majority of proposed revisions and additions to the current CMC rules lack precision and/or definition.
In most instances, the costs and resources necessary to implement these proposed changes by far exceed the estimates CMC has indicated. For example, the costs related to implementing the suggested changes to the Requirements of Participation are underestimated in the proposed rule. If the rule remains the same after finalization, the cost of implementation will surpass the estimates indicated for the economic impact. According to estimates provided by CMC, the cost projected for complete compliance with the requirements of the rule is an aggregate $46 thousand per institution for an estimated $729 million total. This total shows that each facility would have an average cost estimate of $127 per day per facility or rather $1.45 per day per resident. Naturally, this estimate is far too low to coincide with the actual cost requirements of daily healthcare.
References
Dickson, V (2015).Nursing home facilities up in arms over new rules.Modern Healthcare, Retrieved from http://www.modernhealthcare.com/article/20151016/NEWS/151019928
Haskins, J (2015). Stakeholders comment on CMS' proposed rule for long-term care facilities. Washington: The Advisory Board Company. Retrieved from http://search.proquest.com.library.svsu.edu/docview/1724117834/4DA71CD3E52F4492 PQ/44?accountid=960
Stein, M. M. (2015). AHCA sees unfunded mandates in CMS' updated conditions of participation.InsideHealthPolicy.Com's Daily Brief, Retrieved fromhttp://0- search.proquest.com.library.svsu.edu/docview/1695982362/4DA71CD3E52F4492PQ/14 ?accountid=960
