April 24, 2024
On April 22, the Centers for Medicare and Medicaid Services (CMS) announced the U.S. Department of Health and Human Services’ (HHS) three rules to support nursing home residents and caregivers.
Rule 1: Nursing Home Minimum Staffing Standards
Ensuring enough nursing home staff is essential for residents to receive dignified, quality care. Medicare- and Medicaid-certified nursing homes will be required to:
- Provide residents with a minimum of 3.48 hours of nursing care per day, including .55 hours of care from a registered nurse.
- Have a registered nurse available on-site 24/7 to deliver critical care if needed
- Conduct annual facility assessments
- Develop a plan to increase staff retention
Rule 2: Access to Medicaid Services
The ‘Access Rule” sets new standards to improve access to care for Medicaid and CHIP enrollees. The new standards will strengthen both home and community-based services. This rule will:
- Set minimum payment standards for direct care workers
- Increase Medicaid consumer engagement
- Advance provider rate transparency
Rule 3: Managed Care for Medicaid and Children’s Health Insurance Program
The “Managed Care Rule” aims to improve access to care, accountability, and transparency for Medicaid and CHIP enrollees in a Managed Care plan. This rule will:
- Mandate appointment wait times
- Allow comparison for plans based on quality and access to providers
These new rulings build on President Biden’s action plan for improving the safety and quality of care in nursing homes and support the Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers.
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