CMS Updates Released

Nancy Leveille and Jackie Pappalardi in Clinical & Quality

CMS released an update on the ROPs, Arbitration Agreements, Infection Prevention and new materials that can be used to measure staff satisfaction. AHCA has summarized the information below and provided links to each element as needed.

We encourage members to review each section, download CMS resources and involve the specific departments that manage each issue to keep up to date on CMS expectations and state survey agency’s surveillance directives.

On November 22, 2019, the Centers for Medicare & Medicaid Services (CMS) released a memo (QSO-20-03-NH) entitled "Updates and Initiatives to Ensure Safety and Quality in Nursing Homes." The memo includes updates and announcements on several topics that are listed below. A detailed summary can be found here

  1. Phase 3 Interpretive Guidance: CMS will not be releasing interpretive guidance (IG) for the Requirements of Participation Phase 3 until the second quarter of 2020. At that time, CMS will release information on training and related changes to the Long Term Care Survey Process. CMS writes that the Phase 3 regulations will be effective as of November 28, 2019, and facilities will be expected to comply with all requirements; however, CMS and State Survey Agencies (SSA) will have limited ability to survey for compliance with these requirements until the IGs are released. For more information on what this means to you, click here.
  2. Arbitration Agreements: On July 18, 2019, the Department of Health and Human Services published a final rule establishing requirements related to the use of binding arbitration agreements. This final rule amends the requirements that Long-Term Care facilities must meet to participate with Medicare and Medicaid. These requirements were effective as of September 16, 2019, and facilities are required to comply with these requirements. CMS writes that arbitration IGs will be published in the upcoming weeks. AHCA's updated model arbitration agreement and other related resources are available by clicking here. You can also listen to an AHCA webinar on complying with the regulation here.  
  3. Infection Prevention and Control: CMS announced that in an effort to continue to focus on infection prevention and control issues, CMS has created a nursing home antibiotic stewardship program training that will be available here on December 2.  It also updated the Nursing Home Infection Control Worksheet as a voluntary self-assessment tool for centers available here starting on December 2.  In addition, CMS is reminding centers about available infection control resources. For more information, click here.
  4. New Toolkit on Employee Satisfaction: CMS is releasing a new Toolkit, "Guide to Improving Nursing Home Employee Satisfaction." This is the third of three toolkits developed as part of the Civil Money Penalty Reinvestment Program in a series focused on improving staff competency and employee satisfaction. All three toolkits can be found here.

Members may contact CMS at for questions regarding any topics in the memo. 

AHCA Contact:


Nancy Leveille, RN, MS
Executive Director
518462-4800 x20

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