In response to released guidance for Requirements of Participation (RoP) Phase 3 and updates for Phase 2, the American Health Care Association (AHCA) is providing focused information to help skilled nursing facilities remain in compliance and avoid any failed practice. We give special thanks to the AHCA Survey and Regulatory staff for compiling and distributing this information. Elena Madrid, WHCA's Executive Vice President for Regulatory Affairs, co-chairs the AHCA Survey and Regulatory Committee and is a member of AHCA's Quality Cabinet.

The Centers for Medicare and Medicaid Services made changes to the §483.10-Resident Rights. Changes include the following: 

• F557-Respect, Dignity/Right to Have Personal Property. CMS added guidance related to staff searches, signs, symptoms, and triggers of possible substance use, referrals to law enforcement and references to other areas of noncompliance.  
• F561-Self Determination. CMS added guidance related to facility smoking policies.  
• F563-Right to Receive/Deny Visitors. CMS added guidance related to denying visitor access, visitation during communicable disease outbreaks, triggers of substance use after visits, referrals to law enforcement, staff searches, and references to other areas of noncompliance. 
• F582-Medicare/Medicaid Coverage/Liability Notice. CMS made changes to align with the Medicare Claims Processing Manual and simplified the Notice of Medicare Non-coverage (NOMNC) form and SNFABN form.  
• F587-Request/ Refuse/ Discontinue Treatment. Formulate Advance Directives-CMS changes were technical as they corrected a tag reference under the key elements of noncompliance.  

Be sure to order a copy of The Long-Term Care Survey, Phase 3 Guide.

Detailed information can be found in the Appendix PP-State Operations Manual. AHCA has also provided an expanded and full summary. If you have any questions, please email or call me at (800) 562-6170, extension 105.