Wednesday, April 18, 2018

HCBS Settings Rule: Spotlight on Memory Care


Lilly Hummel

NCAL Publishes Policy Briefs on HCBS Settings Rule

To support states and providers implementing the Home and Community Based Services (HCBS) Settings Rule, NCAL has partnered with Health Management Associates to create four policy briefs that address areas that have been particularly challenging to ensure that assisted living (AL) continues as an appropriate home and community based setting. These briefs provide background on each issue, aggregate the available guidance from the Centers for Medicare and Medicaid Services (CMS), and provide examples of CMS-approved strategies to comply with the rule from those states with approved transition plans.

This week NCAL is spotlighting its brief on Memory Care: An Effective Person-Centered Planning Process Is Key for Memory Care Units. CMS guidance emphasizes the crucial importance of a person-centered planning process for individuals with dementia. This includes the meaningful choice of setting (including one with controlled egress), ensuring that any modifications to the protections of the rule are based on a person-centered process and respond to a specific individual need, and how best practices in dementia care can assist with compliance with the rule and improve overall care. The brief also summarizes a variety of best practices in dementia care, including publications from the Center for Excellence in Assisted Living, the Alzheimer’s Association, CCAL, and the Administration for Community Living.

Since 2014, implementation of has been underway to meet the extended 2022 deadline. States continue to work with CMS to have their transition plans approved. States must also assess all HCBS settings for compliance with the rule, and then assemble evidentiary packages for CMS heightened scrutiny review for settings that meet certain criteria.

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