CMS Reforms Transform Long-Term Care: Key Changes for Nurses and Facilities

Recent CMS guidelines will reshape long-term care practices, focusing on admissions, medication management, infection control, and health equity, effective February 2025.

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Recent CMS Guidelines for Long-Term Care

Recent CMS guidelines aim to reshape long-term care practices, with sweeping reforms set to take effect in February 2025.

The updated survey guidelines for nursing homes address admissions, medication management, infection control, and health equity, representing a significant shift in how facilities will operate moving forward.

Nurses working in skilled nursing or long-term care settings must be proactive in understanding these changes to maintain compliance and improve resident outcomes.

Admissions and Care Decisions

One of the most notable changes involves admission agreements.

Facilities are now prohibited from requesting third-party payment guarantees, eliminating coercive financial pressure on residents or their families [1].

This aligns with broader trends in prioritizing patient-centered care.

For example, AI-driven approaches in healthcare—like personalized treatment plans based on real-time data—are reshaping how care is delivered, with tools that integrate data from radiology, genomics, and patient wearables to inform decisions [2].

In long-term care, this could translate to more individualized support during admissions, ensuring residents’ medical needs are prioritized over financial considerations.

Medication Management Updates

The CMS revisions also tackle psychotropic medication protocols.

Residents must now explicitly consent to or refuse such medications, a requirement designed to enhance patient autonomy [1].

This echoes growing discourse about nonpharmacological interventions in mental health, such as mindfulness or tai chi, which are gaining traction as evidence-based alternatives [3].

Nurses will need to balance these pharmacological and nonpharmacological approaches, particularly as CMS tightens scrutiny around antipsychotic use and documentation.

Infection Control and Equity

Infection prevention is another focal point, with expanded guidelines for MDROs and COVID-19 vaccines.

Facilities are required to educate residents and staff on vaccine benefits and risks, reflecting ongoing efforts to integrate public health training into clinical workflows [1].

Additionally, CMS mandates health equity assessments within Quality Assurance and Performance Improvement (QAPI) programs, requiring facilities to track disparities tied to race, socioeconomic status, or language [1].

This aligns with initiatives like Johns Hopkins’ Nursing Science Incubator for Social Determinants of Health, which aims to dismantle systemic inequities through nurse-led innovation [3].

Training and Implementation

To support these changes, CMS will deploy updated surveyor training via the Quality, Safety, and Education Portal (QSEP) and integrate revised guidelines into the Long-Term Care Survey Process (LTCSP) software by February 24, 2025 [1].

Nurses should leverage these resources to stay ahead of compliance deadlines.

Collaborative models like Johns Hopkins’ School Health Nursing program—combining nurse training with community partnerships—offer glimpses of how interdisciplinary approaches can address complex care needs [3].

Conclusion

For nurses navigating these reforms, dedicating time to CMS’s guidance documents and QAPI tools will be critical.

The move from “sick care” to preventive, value-based models—a theme underscored by nursing leaders—is not just aspirational but now codified in federal policy [3].

By marrying compliance with innovation, nurses can help facilities meet the letter of the law while leading the charge toward more equitable, patient-driven care.

Read the full CMS guidelines here for detailed insights into survey process updates.

For broader context on healthcare trends, explore Philips’ analysis of AI integration in care delivery and Johns Hopkins’ 2025 health care forecast.

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