Healthcare Compliance Updates – New ROP Changes

Healthcare Compliance Updates – New ROP Changes

As we all know the new Requirements of Participation (ROP) for Skilled Nursing Facilities (SNF) were published in the Federal Register on October 4, 2016 with the Phase 1 requirements going into effect on November 28, 2016.  The Requirements of Participation have not been significantly altered in nearly 25 years.  So as you can imagine, there are some significant changes that come with these new Requirements.

The initial changes which went into effect in November required limited changes by the SNF operators but those changes coming in years two and three will require significantly more planning, education and implementation activities.  These new requirements focused on three major areas; Person-Centered Care, Facility Assessments and implementing the Affordable Care Act provisions as required.

Another significant change we will see in 2017 is the enforcement of these new Requirements through the State Survey process.  Surveyors will begin receiving training regarding the new survey process to assess compliance sometime this spring/summer with surveys beginning on November 28, 2017.  Providers should begin watching for materials issued by CMS regarding the modified survey process as the year unfolds.

As healthcare compliance professionals, we should be part of the inter-disciplinary team working on the analysis of the requirements, gap analysis process, the remediation and the implementation of the new requirements.  Not to mention leading the initiative to implement the Compliance and Ethics Program required in Phase 3.

Even though the Compliance Ethics Program is not required until Phase 3 there are things that you can be working on over the course of the next two years.  To begin, you can evaluate your current program by reviewing the Office of Inspector General (OIG) Guidance that has been published specifically for SNFs as well as looking at your internal processes for effectiveness.

Ask yourself if your Hotline is effective.  Do employees feel comfortable reporting potential compliance concerns?  Have you updated your compliance education materials recently or do they need a little refresh?  You have plenty of time but don’t wait to the last minute because as we know in the Compliance world, you never know what new issue will arise each day that will divert you from your best-intentioned plan.

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