Final Rules Issued
The final rules have been issued by the Centers for Medicare and Medicaid Services (CMS) for long term and subacute providers. Providers feel that the new rules are impossible to meet in the time frame provided.
The issue is not that the patient care centered changes are not appropriate or even long over due. The issue for the providers is the timeline and the work force requirements. Under the current timeline for implementation the providers believe that they are being set up for failure. The regulations and the timeline fail to recognize the difficult workforce environment, the lack of specific guidelines and resources to implement them. Without specific guidelines and resources to hire and train existing and new staff the providers believe that compliance is next to impossible.
The providers particularly in rural areas feel that they will be hit with survey deficiencies and large fines. They could be put out of business resulting in a negative impact on the community and current residents/patients. The providers in many cases are a large employer in these rural communities and their closing could have a devastating effect on the local employment picture and the economy.
These new rules tying staff competency to the specific unit and or patient population on the unit will take time for providers to meet. They must first develop specific programs to test competency and than these programs are turned into new educational tools. Once this is completed they then must test the staff, document the test and then provide educational programs to fill the holes in the competencies. In the end whether or not a staff member has the specific competencies will be subject to survey review and without guidelines be a subjective one at best.
Providers are being left to hire, train, retrain and then certify to competencies without CMS providing them with guidelines for such a monumental task. In addition no new resources are being provided to cover the cost of such a “new” and time consuming process.
It is hoped that the new administration and its picks for heads of agencies like CMS will select people who sympathize with the providers and make the necessary adjustments in the new rules.