Every skilled nursing facility that is certified to provide care to Medicare and Medicaid beneficiaries must comply with both Massachusetts State regulations as well as Federal Requirements of Participation and all applicable local laws, regulations, codes, and according to professional standards.
To obtain information on State regulations for Long-Term Care Facilities
- Department of Public Health, Bureau of Health Care Quality Regulations
- Department of Public Health Long Term Care Circular Letters
- MassHealth Long Term Care Facility Provider Bulletins
- Department of Public Health information and training resources for Long Term Care Survey Process (LTCSP)
In October 2016, the Centers for Medicare and Medicaid Services (CMS) published a final rule revising the Medicare and Medicaid Requirements of Participation (RoP) for nursing centers. This represents the first comprehensive revision to the regulations since 1991. The implementation of these new requirements will occur in 3 phases.
Phase 1: effective November 28, 2016
Phase 2: effective November 28, 2017
Phase 3: effective November 28, 2019
In addition, the CMS implemented a new survey process effective November 28, 2017. The New LTC Survey Process is resident-centered, which means resident-specific concerns identified through resident observations and resident or representative interviews are emphasized. The New LTC Survey Process provides as much structure as possible to ensure consistency while allowing surveyors the autonomy to make decisions based on their expertise and judgment.
The survey protocols and interpretive guidelines serve to clarify and/or explain the intent of the regulations. All surveyors are required to use them in assessing compliance with Federal requirements. Deficiencies are based on violations of the regulations, which are to be based on observations of the nursing home’s performance or practices.
- CMS website for the Requirements of Participation and the new Survey Process resources
CMS Policy & Memos to States and Regions
- CMS Survey and Certification memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices
CMS Training Resources
- CMS Provider Training Video
This one-hour training video for providers explains the rationale for adopting a new survey process, detailed guidance on how to complete the “Matrix for Providers” (resident roster), and key changes to regulatory requirements applicable to nursing homes, such as antibiotic stewardship.
- CMS Topical Training Videos for Surveyors and Providers
The full list of CMS videos created for the training of state survey staff on the Long Term Care Survey Process is provided below. Providers may also access each of these videos by clicking on the individual video title and slides or by clicking the link above and selecting “Launch the Course.” Depending upon the settings of your computer, it may be necessary to access these videos via Google Chrome.
Individual topics include:
- Admission, Transfer, and Discharge (8/4/2017) & Slides
- Appendix PP – Overview of Revised Interpretive Guidance (8/4/2017) & Slides
- Behavioral Health (8/4/2017) & Slides
- Facility Assessment (8/4/2017) & Slides
- Freedom from Abuse, Neglect, and Exploitation (8/4/2017) & Slides
- Infection Control (8/4/2017) & Slides
- Person-Centered Care (8/4/2017) & Slides
- Pharmacy Services (8/4/2017) & Slides
- Quality Assurance and Process Improvement Plan – The Basics (8/4/2017) & Slides
- Quality of Life and Quality of Care (8/4/2017) & Slides
- Nursing Services (8/4/2017) & Slides
CMS survey-related forms
Use these links to access fillable versions of the CMS forms that must be completed during the survey:
- Critical Element Pathways
- Entrance Conference Worksheet and Matrix for Providers (with instructions)
- CMS 671
- CMS 672
- Massachusetts Attorney General’s Regulations for Long-Term Care Facilities
- Office of the Inspector General LEIE Database and Exclusions
- National Nursing Home Quality Improvement Campaign
- AHCA Provider Resources (Requires AHCA/NCAL Login)
- Center for Disease Control
For additional information regarding Regulatory or Survey, please contact Helen Magliozzi, Director of Regulatory Affairs.