Assisted living providers could be affected in three ways by the Centers for Medicare and Medicaid Services’ proposal to reform the requirements that long-term care facilities must meet to participate in Medicare and Medicaid programs, according to the National Center for Assisted Living:

  1. Transitions of care. Changes to transitions of care and discharge planning could affect access of care and choice of provider for residents, according to the American Health Care Association/NCAL.

  2. Naming a resident representative when a court-appointed representative or other person legally already has been designated by a resident (for instance, via a durable power of attorney or living will) will add confusion when skilled nursing residents are discharged to an assisted living community and the resident representative no longer has a legal role, AHCA/NCAL maintains. Instead, the organization recommends that a resident representative be named only when a court has not appointed someone or a resident has not named someone via a durable power of attorney or living will.

  3. Arbitration agreements. AHCA/NCAL is recommending that arbitration agreements not be eliminated because they “are a valuable tool to manage risk.” Insurers base their rates on whether an assisted living provider uses arbitration agreements, the organization notes. Changes in the use of arbitration agreements in skilled nursing centers will affect rates and accessibility to assisted living providers, AHCA/NCAL adds.

NCAL is asking its members to write to CMS before the Sept. 14 comment deadline. On its website, AHCA/NCAL has posted a letter template for use by those who work in assisted living.