Overview of New CMS Nursing Facility Requirements of Participation


Steven Levenson, MD, CMD; David Nace, MD, MPH, CMD; Karl Steinberg, MD, CMD

This webinar describes changes in the federal nursing home regulations (Requirements of Participation) as revised in a Final Rule published in October 2016, including themes of person-centered care, Quality Assurance/Process Improvement (QAPI), pharmacy issues, behavioral health, and more. There is a particular emphasis on changes impacting the medical director, attending physicians, nurse practitioners, physician assistants, and other clinicians who work in the skilled nursing facility setting.

Learning Objectives

  • Describe major changes of the new Requirements of Participation (RoPs) and how they impact medical directors and other clinicians.
  • Prepare for implementation of the new regulations, considering the timing of each phase of adoption.
  • Explain the QAPI process that facilities will be required to develop.
  • Describe the focus on antibiotic stewardship and Infection Control in the Final Rule.
  • Interpret the use of the term “psychotropic drugs” as it relates to pharmacy services in the Final Rule.



1.5 management

CME/CMD Credits Available until November 2019

Nursing Credits:
This continuing nursing education activity was approved by the Maryland Nurses Association an accredited approver by the American Nurses’ Credentialing Center’s Commission on Accreditation.”

Program Code: LA16-12-524-301 1.5 contact hours

Contact hours available until May 24, 2019.

Member Non-Member
FREE $99


Speaker Biography:

Steven Levenson, MD, CMD, has spent 37 years working in PALTC settings as a physician and medical director. He has been medical director of 22 PALTC facilities in Maryland and is also currently responsible for overseeing multiple facilities in other states. Dr. Levenson has authored or co-authored several books and articles, including “Medical Direction in Long-Term Care,” the first book about how to be a medical director, and “Sub-acute and Transitional Care Handbook,” the only comprehensive, clinically-oriented reference on the topic of post-acute care. He is widely recognized for his pioneering work in medical direction and efforts to improve geriatrics and long-term care. For the past 29 years, Dr. Levenson has played a major role in developing the Society and helping extend its influence. He was the AMDA President from 2006-2007.

David Nace, MD, MPH, CMD, is an Associate Professor of Medicine in the Division of Geriatric Medicine at the University of Pittsburgh. He serves as the Director of LTC and Influenza Programs for the division and as Chief of Medical Affairs for UPMC Senior Communities. Dr. Nace chairs the Society’s Infections Advisory Committee; is a member of the Advisory Committee on Immunization Practice’s (ACIP) Hepatitis B Workgroup; a member of the National Influenza / Adult Immunization Summit; and Co-Medical Director of the UPMC RAVEN project, a CMS innovation award project seeking to reduce unplanned admissions from nursing facilities. He has participated in a variety of National Institutes of Health, CMS, Health and Human Services, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality AHRQ) projects. Currently, he is working on several AHRQ funded projects addressing antimicrobial stewardship in the LTC setting, including the Society supported demonstration project, Improving Outcomes for UTI Management (IOU Study).

Karl Steinberg, MD, CMD, has been a nursing home and hospice medical director, attending physician, and educator in San Diego for over 20 years and is editor-in-chief of Caring for the Ages, in addition to serving on multiple Society committees, and previously on the Board of Directors. He is a frequent risk management consultant and expert reviewer and witness in medicolegal matters, including numerous cases with pressure ulcers and other wounds as primary drivers of litigation.

Speaker Disclosures:

All members of the education and online education committees have no financial relationships to disclose. Society staff have no financial relationships to disclose. Speakers of this program have no financial relationships to disclose.