Issue: July 17, 2019

Published on July 17, 2019

Articles in this issue:

CMS Final Rule Proposes One-Year Delay of some Phase III Requirements, Allows Arbitration Agreements, and Allows Use of 2001 FSES

Author: Lisa Volk and Jackie Pappalardi Allison Gold* Published in Clinical & Quality

The Centers for Medicare & Medicaid Services announced last evening the proposed delay of some Phase III requirements until November 28, 2020.

CMS Proposes Rule to Delay Implementation of Phase 3

CMS has proposed a draft rule that would delay the implementation of some Phase 3 requirements for one year from the original November 2019 date, including components of the Quality Assurance and Performance Improvement (QAPI) requirements and portions of the Compliance and Ethics Program requirements. More information can be found here.

CMS Issues Final Arbitration Rule

On Tuesday, CMS released a final rule banning nursing homes from requiring residents to sign binding arbitration agreements as a condition for admission, a reversal of the agency’s previous policy proposal. The final rule states that while arbitration agreements are permitted, facilities are required to inform and put in writing for patients that the patient does not have to enter into the agreement to receive care. Nursing homes must retain copies of signed binding arbitration for at least five years from the date of any dispute resolution and make those documents available for inspection. The final rule also prohibits nursing homes from preventing communications by residents or their families to State surveyors. The final rule is scheduled for publication on July 18, but the unpublished PDF can be found here.

CMS Proposed Change to the Requirements of Participation: Physical Environment (§483.90)

CMS proposes to allow older existing LTC facilities to continue to use the 2001 Fire Safety Equivalency System (FSES) mandatory values when determining compliance for containment, extinguishment, and people movement requirements. This proposal would allow older facilities who may not meet the FSES requirements in the recently adopted 2012 Life Safety Code (LSC) to remain in compliance with the older FSES without incurring substantial expenses to change their construction types, while maintaining resident and staff safety. The proposal is scheduled for publication on July 18, but the unpublished PDF can be found here.


Allison Gold
Director of Policy & Reimbursement
518.462.4800 x25

Lisa Volk
Director, Clinical & Quality Services
518-462-4800 x15 

Jackie Pappalardi
Director, Educational Development & Grant Management
518-462-4800 x16

DOH: Heat Advisory

Author: Lisa Volk and Jackie Pappalardi* Published in Clinical & Quality

With the arrival of extended periods of high temperatures and humidity, you are encouraged to take the necessary precautions to prevent heat related illnesses. Residents with a history of dehydration, cardiovascular and/or pulmonary disease are particularly susceptible to heat related illnesses and complications. To assist in preventing heat illness among your residents during the hot and humid weather, it is recommended that all staff be especially alert to the signs, symptoms and consequences of heat prostration, heat stroke and heat cramps. See full DAL attached.


Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Jackie Pappalardi, RN, BSN
Director, Educational Development & Grant Mgmt
518-462-4800 x16