CMS Final Rule – Freedom from abuse, neglect, and exploitation (§483.12)

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Implementation Date: Phase 1 – November 28, 2016 except for (b)(4) Coordination with QAPI plan – implemented in Phase 3 (November 28, 2019) and (b)(5) reporting crimes/1105B – Implemented in Phase 2 (November 28, 2017)

Section 483.12 has been changed to “Freedom from Abuse, Neglect and Exploitation” from “Resident Behavior and Facility Practices” in order to more accurately reflect the content. Under the new rule, facilities must not employ individuals who have a disciplinary action in effect against his or her professional license by a state licensure body as a result of a finding of abuse, …” This provision, as finalized, will prohibit facilities from employing certain individuals who have a disciplinary action in effect against a professional license. This provides facilities some flexibility to exercise discretion with regard to previous disciplinary actions. Where a facility is aware of previous disciplinary actions against a professional license, but those actions have been resolved, the facility makes their own hiring decisions based on the specific nature and circumstances of those previous disciplinary actions and in keeping with their responsibility to protect the health and safety of residents.

§483.12(c)(1) has been revised to require that all allegations of abuse be reported immediately, but not later than 2 hours after allegation is made, and allegations of neglect or exploitation to be reported to the administrator of the facility immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, or not later than 24 hours if the events that cause the suspicion do not result in serious bodily injury. All allegations of abuse, with or without injury, fall into the immediate reporting category, as we believe it is imprudent to allow delay reporting of any abuse. Furthermore, we note that the 2 hour and 24 hour time frames represent maximums and we would expect that most reports would occur more quickly. In all cases, we would expect prompt action to protect individuals and address concerns, and delays in reporting, even within the allowable time frames, must be reasonable and not be related to attempts to obscure events or evade responsibility. The results of all investigations must be reported to the Administrator or her designated representative.

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By Cassie Lewandowski

Cassie Lewandowski 2

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