Regulatory Outlook for 2019

Regulation | November 08, 2018 | by Janine Finck-Boyle

At the LeadingAge annual meeting in Philadelphia, participants in the Health Policy Forum got to hear from Karen Tritz, director of the Division of Nursing Homes in the Centers for Medicare and Medicaid Services (CMS)’ Quality and Safety Oversight Group.


In her presentation, Ms. Tritz focused on the long term care survey process, Phase 3, Requirements of Participation(RoPs), facility-reported incidents, Immediate Jeopardy, Payroll Based Journal (PBJ) audits and time-limited waivers.

Ms. Tritz reviewed the top deficiencies for which nursing homes have been cited, pointing out that in the new survey process the average number of deficiencies has been on par with both the traditional and QIS survey process from year 2017. The traditional and QIS processes averaged 5.8 deficiencies and the new survey process has averaged 6.26 deficiencies.

Other policy issues discussed were the RoPs, Phase 3 Interpretive Guidance and the unfreezing of the Health Inspection Rating on Nursing Home Compare.  Ms. Tritz stated both of these programs and processes will be coming towards the spring of 2019.  She also discussed the revisions to the Immediate Jeopardy, Appendix Q guidance and reviewed clarification of facility-reported incidents, outlining actions.

Although PBJ is not Ms. Tritz's primary responsibility, she did give an overview of the audit process and lessons learned with common errors to avoid.  She ended her presentation by delving into time-limited waivers.

Members attending the forum had the opportunity to ask specific questions of Ms. Tritz and share their comments and thoughts about the long term care survey and certification process.