What’s new: CMS posted QSO-24-13 on June 18, 2024. The memo includes the revised guidance for state surveyors for the Long-term Care Facility Assessment regulation that is part of the CMS staffing mandate.

• Remember, the revision to the facility assessment regulation at F838 must be implemented by August 8, 2024.

Per the memo, the revised regulatory requirements have been moved from 42 CFR 483.70 to 42 CFR 483.71. Existing regulations at 42 CFR 483.70(f) through (q) have been re-designated as paragraphs (e) through (p), respectively.

• The revised guidance notes that surveyors should determine whether a facility assessment contains the required components under the regulation; they should not evaluate the quality of the assessment.

The details: Areas added to the guidance to determine compliance include but are not limited to the following:

• The facility assessment includes an evaluation of the resident population, and its needs (e.g., acuity) based on evidence-based, data driven methods.
• The facility assessment reflects the population.
• The facility assessment addresses the facility’s resident capacity.
• The facility assessment includes information on the staffing level(s) needed for specific shifts, such as day, evening, and night and adjusted as necessary based on changes to resident population.
• The facility assessment addresses what skills and competencies are required by those providing care.
• The facility assessment is conducted with input from the individuals stated in the regulation (483.71(b)).
• The facility assessment indicates what resources, including but not limited to, equipment, supplies, services, personnel, health information technology, and physical environment are required to meet all resident needs.
• The facility has a plan for maximizing recruitment and retention of direct care staff.
• The facility assessment includes a contingency plan that is informed by the facility assessment.

Next steps: AHCA is reviewing the guidance and will share helpful resources soon. AHCA has previously prepared this Action Brief to help nursing facilities navigate the new requirements.

• Please reach out to regulatory@ahca.org with any questions.