A Quick Look at Updated CMS Guidelines

Over the past year or so the Centers of Medicare & Medicaid Services (CMS) has issued a number of regulation changes, including new guidelines for nursing home surveyors. Along those same lines, and in order to continue improving nursing home care, CMS has released more comprehensive changes to nursing home regulations. These guidelines come as phase 3 of planned changes released by CMS to combat the poor quality of nursing home care across the U.S. The latest Phase 3 regulations come post-pandemic, and address some key issues. Below, we wanted to give you a quick look at the new CMS guidelines for nursing home regulations and showcase some important areas of improvement.


Visitation rules and regulations were on everyone’s minds during the pandemic, with loved ones unable to see family members in nursing homes, and residents isolated without visitors. This is one area that CMS wanted to improve. To do so, they are now offering ways to help nursing home facilities address and maintain visitation during disease outbreak. Some of their suggestions include: 

  • “Outdoor and virtual visitation.
  • Designated indoor visitation areas.
  • Appropriate infection control.
  • Contacting local health departments”

Visitation rights are essential to maintaining and promoting health among nursing home residents. It’s vital that visitation rights be unrestricted and nursing homes do everything in their power to allow visitation.

Identifying Neglect

CMS guidance always includes regulations surrounding neglect, but the new rules have added language from the Code of Federal Regulations which states: “the failure of the facility, its employees or service providers to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish or emotional distress.”

This addition expands the definition of neglect for nursing home surveyors, helping them to better identify instances of neglect.

Crime Reporting

Unfortunately, identifying neglect or abuse only goes so far to stopping its recurrence. The new CMS regulations have added guidance for surveyors on how to enforce the section of the Affordable Care Act that required nursing home staff to report abuses to law enforcement. Surveyors are now directed to make sure facilities have a crime reporting protocol in place and that all staff and other personnel are aware of the policies.

Arbitration Agreements

Arbitration agreements are routinely slipped into nursing home admission paperwork, and have been for decades. These agreements often bind residents into an agreement that they will settle all grievances out of court. However, in more cases than not, arbitrations do not favor the resident, making these agreements an easy way to take advantage of individuals at a vulnerable stage in life. 

The new CMS regulations still allow these agreements but require that:

  • “They be consented to and agreed to voluntarily by residents.
  •  Explained in a manner that a resident or her representative understands.
  • Allow for 30 days to rescind the agreement.
  • Be distinguishable from other intake documents.
  • Cannot be a condition of admission or a reason to transfer or discharge a resident.
  • Must provide for a neutral arbiter.
  • Facilities must keep a copy of the arbitration agreement and any arbitration decision for five years, should a dispute go to arbitration.”

These are just a few of the areas of nursing home care and services that will be improved with the new CMS regulations. To read the full Consumer Voice summary, click here.

If you or a loved one have been a victim of nursing home abuse, call Gharibian Law (877-875-1119) today for a free consultation and the best legal representation.