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June 6, 2017

CMS Reverses Course on
Pre-Dispute Arbitration

Eight months after publishing a final rule on the Revised Requirements of Participation for Nursing Facilities banning pre-dispute arbitration agreements for nursing home residents and family members, CMS is issuing new proposed rules that rescind resident protections against these unfair provisions.

In the proposed rule, CMS removes the requirement preventing facilities from entering into pre-dispute arbitration agreements, and also removes the provision banning facilities from requiring these agreements as a condition of admission.

Instead, CMS requires that an agreement for binding arbitration be explained to the resident and his/her representative in a manner that s/he understands, and that the resident acknowledges that s/he understands the agreement.   The agreement may not prohibit or discourage the resident or anyone else from communicating with federal, state, or local officials, including the survey agency and the long-term care ombudsman program.

Additionally, CMS requires that the arbitration agreement be in plain language; and if it is a condition of admission, that it be in plain writing in the admission contract.  Lastly, CMS is proposing that facilities be required to post a notice describing its policy on the use of agreements for binding arbitration in an area that is visible to residents and visitors.

Gone from the rule is not only language banning pre-dispute arbitration as a condition of admission, but also requirements from the 2016 final rule for post-dispute binding arbitration that the agreement be entered into voluntarily by the resident, that a neutral arbitrator be mutually agreed upon, and that the venue for arbitration be convenient to both parties.  

For more information, click here.

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CMS Is Asking for Comments

On May 4, 2017, the Centers for Medicare and Medicaid Services (CMS) put out a request for comments on several items.

First, CMS is reviewing three (3) parts of the revised federal nursing home regulations for possible modification or removal "in an effort to reduce the burden and financial impact imposed on LTC facilities."  The three areas are:

  • discharge notices to ombudsmen
  • the grievance process
  • the Quality Assurance and Performance Improvement (QAPI) provisions

The full text can be found in the Federal Register, Vol. 82, No. 85, Thursday, May 4, 2017, pp.21088, or see here.

The revised regulations can be found here. Refer to the following sections:  discharge notices to ombudsmen - 483.15(c)(3)(i); grievance process - 483.10(j); QAPI - 483.75.  

Secondly, CMS is considering changes to Medicare reimbursement for skilled nursing facilities which would significantly change the financial incentives to facilities for providing therapy.  According to an analysis by the Center for Medicare Advocacy:  Proposed changes to nursing facility payment under consideration by CMS would reduce financial incentives to provide therapy, and would do so with such force - providing higher reimbursement to skilled nursing facilities (SNFs) that provide fewer types of therapy to residents over a shorter period of time or no therapy at all - that it would actually encourage facilities not to provide therapy.  Further, the Jimmo v. Sebelius mandate to cover maintenance therapy would be completely ignored. (See the Center for Medicare Advocacy's Alert at CMA Alert, May 17, 2017).  The full notice can be found on the Federal Register's website.

What is Consumer Voice doing?
Consumer Voice is preparing comments on these issues and would encourage you to do so as well.  We will soon make additional information available.

When are comments due?  And how do I submit them?
Comments are due June 26, 2017, and the best way to submit comments is electronically.  Go to www.regulations.gov.  Within the search bar, enter the Regulation Identifier Number associated with this regulation - 0938-AS96 - and then click on the "Comment Now" box 2.

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Online Course Available on Prevention of Abuse and Nelect

On June 12, American Society on Aging and USC Leonard Davis School of Gerontology are launching a five-week online course on Elder Mistreatment: Prevention of Abuse and Neglect.  Experts from USC's faculty provide information on what is known about prevention within the field of elder mistreatment, and cover options and remedies for protecting victims of elder mistreatment, as well as strategies to prevent elder mistreatment. Find out more by watching this video.  Participants can earn a certificate of completion from USC, and elect to receive 10 CEUs from select accreditation providers. Click here for more information and to register today.

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Justice in Aging Webinar on Attacks on Medicaid

Join Justice in Aging Wednesday, June 14th at 1:00pm ET for a webinar entitled "Medicaid Under Attack."  This webinar will provide a summary of how the Medicaid cuts and caps in the AHCA would impact low-income older adults, including how they would affect seniors who rely on Medicaid and Medicare. It will also discuss the other potentially harmful impacts of the AHCA for older adults and provide an update on the Trump Administration's budget proposal.  Register here.

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Preparation for Social Security Number Removal Initiative

Beginning April 2018, CMS will start mailing Medicare cards with new Medicare Beneficiary Identifiers (MBI) to all people with Medicare.  The MBI will replace Social Security Number-based Health Insurance Claim Numbers for transactions like billing, eligibility status and claim status.  In preparation for this change, CMS suggests the following steps:

For more information, click here.

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Attend VOYCE's Long Term Care Conference

VOYCE St. Louis is holding its 2017 Changing the Landscape of Long Term Care Conference on June 8 at the Renaissance St. Louis Airport Hotel and June 9 at Frienship Village Sunset Hills. Hear national and local experts discuss dynamic strategies, innovative tools and available long-term care options. The format has been set with two educational tracks throughout the conference on June 8; one for professionals working in long-term care and one for the general public who are looking for answers to the complexity of long-term care. June 9 consists of an all-day Post-Conference Intensive on "Doing Better Together: A Nursing Home Leader's Guide to High Performance." Click here for more information and register here.

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Spotlight on Resources

The Consumer Voice and the National Ombudsman Resource Center (NORC) have a multitude of resources available online covering a wide range of long-term care topics.  Visit the Consumer Voice website and the NORC website to explore all the available resources.  Take a look at this week's highlighted resource:

Elder Abuse Resources - World Elder Abuse Awareness Day is June 15th. In preparation, check out Consumer Voice and NORC's resources on identifying, preventing and reporting elder abuse.

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In this Issue

CMS Reverses Course on
Pre-Dispute Arbitration

CMS Is Asking for Comments

Online Course Available on Prevention of Abuse and Neglect

Justice in Aging Webinar on Attacks on Medicaid

Preparation for Social Security Number Removal Initiative

Attend VOYCE's Long Term Care Conference


Spotlight on Resources


Combined Federal Campaign

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Registration is Now Open!

Consumer Voice 41st Annual Conference

November 5-8, 2017
Renaissance Arlington Capital View Hotel
Arlington, Virginia


Calendar of Events

Wednesday, June 14: Medicaid Under Attack, 1:00pm ET, Webinar from Justice in Aging

Thursday, June 15: World Elder Abuse Awareness Day

November 5-8, 2017: Consumer Voice 41st Annual Conference, Arlington, VA


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Wednesday, May 31:
A story by NPR covers several states' attempts to crack down on involuntary discharge from nursing homes.

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Wednesday, May 31:
A recent story by NPR covers several states' attempts to crack down on involuntary discharge from nursing homes


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The Voice is a weekly e-newsletter, published by the National Consumer Voice for Quality Long-Term Care. If you do not wish to continue receiving this publication, please unsubscribe below. Your contributions and comments are welcome and should be sent to info@theconsumervoice.org. Copyright © 2017.

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Consumer Voice is the leading national voice representing consumers in issues related to long-term care, helping to ensure that consumers are empowered to advocate for themselves. We are a primary source of information and tools for consumers, families, caregivers, advocates and ombudsmen to help ensure quality care for the individual. Consumer Voice's mission is to represent consumers at the national level for quality long-term care, services and supports.


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