November 15, 2012
New Transparency Requirements for Nursing Homes
The “Health Care Reform Act” has now passed in the form of the Patient Protection and Affordable Care Act, which was recently upheld by the United States Supreme Court. While the majority of the media’s attention has been focused on the individual insurance mandate, the passage of the Affordable Care Act will continue to have far-reaching implications for skilled nursing facilities, senior apartments and other senior housing facilities.
One facet of the Affordable Care Act is the Nursing Home Transparency Act, which seeks to bring about transparency of information regarding the ownership and operation of skilled nursing facilities. Skilled nursing facilities will be subject to new disclosure requirements under the Social Security Act. A skilled nursing facility will need to disclose:
- Each member of the governing body of the nursing home facility, including the member’s name, title and period of service
- Each person or entity who is an officer, director, member, partner, trustee, or managing employee of the facility, including the name, title, and date of start of service of each such person or entity
- Each person or entity who is an additional “disclosable party.” A “disclosable party” will include an individual who exercises operational, financial or managerial control over the facility.
The required information must be readily available if a request is made by regulatory authorities, including the Secretary of Health and Human Services, the Inspector General for Health and Human Services, or the state long-term care ombudsman. Of course, this also means that the information must be kept up to date if, and when, any changes are made. The Department of Health and Human Services will even be checking to ensure that skilled nursing facilities have assigned specific personnel to verify all the regulations are being followed
In addition to the disclosure of ownership and operation, skilled nursing facilities must be able to produce, to the public, any documents from the past three years regarding surveys, certifications, or compliance investigations. Not only do these documents need to be available, but facilities must post a conspicuous notice informing the public that the facility has these documents available.
Skilled nursing facilities will also be required to provide information regarding real-time nurse staffing levels. In addition, they will need to develop internal quality assurance and performance improvement standards to monitor and improve the quality of care provided to residents.
If a facility fails to comply with these new regulations, the Nursing Home Transparency Act allows for civil monetary penalties. However, if a facility self-reports health deficiencies, where no actual harm or death occurred, the penalties may be reduced by up to 50%.