LeadingAge National Government News: November 27, 2024

On November 20, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) released Industry Segment-Specific Compliance Program Guidance for Skilled Nursing Facilities and Nursing Facilities (Nursing Facility ICPG). Nursing facilities may use the ICPG to help identify their own risks and to implement effective compliance and quality programs to reduce those risks. Together with OIG’s General Compliance Program Guidance (GCPG), the ICPG is a voluntary program that may guide nursing facilities to reduce fraud, waste, and abuse; promote cost-effective and quality care; enhance the effectiveness of providers’ operations; and propel improvements in compliance, quality of care, and resident safety.  

This Nursing Facility ICPG draws on insights and recommendations informed by: (1) findings and observations from the OIG’s decades of work in nursing facilities, including audits, evaluations, investigations, enforcement actions, and monitoring of Corporate Integrity Agreements (CIAs); (2) legal actions initiated and investigated by the OIG in collaboration with its government partners; (3) current enforcement priorities; and (4) engagements and discussions with nursing facility owners, operators, industry leaders, trade associations, resident advocacy groups, and other stakeholders. LeadingAge participated in the OIG’s outreach efforts for the ICPG.  

Under the CMS, Requirements of Participation (RoPs) Phase 3, implemented in 2019, nursing homes are required to maintain a compliance and ethics plan. The recommendations and practical guidance provided in the Nursing Facility ICPG and GCPG can support nursing facilities in meeting these compliance program requirements while also aiding adherence to other statutory and regulatory obligations. LeadingAge will continue to review the ICPG for further potential educational opportunities for providers. 

In a November 20 opinion piece in the Wall Street Journal, Elon Musk and Vivek Ramaswamy, who President-elect Donald Trump named to head a new Department of Government Efficiency (DOGE), outline their three goals: regulatory rescissions, administrative reductions, and cost savings. Referencing the Supreme Court’s 2024 Loper Bright decision, which overturned the Chevron doctrine’s reliance on federal agencies to realize statutory intent, the authors say they will present President Trump with a list of thousands of federal regulations that “exceed the authority Congress has granted under the law” for him to nullify.  

Certainly, LeadingAge counts CMS’s 2024 final rule imposing minimum staffing standards in nursing homes to be among these types of regulations. Mr. Musk and Mr. Ramaswamy also envision actions to reduce the federal workforce through “large-scale firings to relocations of federal agencies outside of the Washington area” and say that “[r]equiring federal employees to come to the office five days a week would result in a wave of voluntary terminations that we welcome: If federal employees don’t want to show up, American taxpayers shouldn’t pay them for the Covid-era privilege of staying home.”  

Mr. Musk and Mr. Ramaswamy say they will act as voluntary advisors to DOGE, which will be staffed with a “lean team of small-government crusaders” who will work to reduce regulations, cut the federal workforce, and reduce federal spending, in part by taking aim at unauthorized expenditures and programs being used in ways never intended by Congress. President-elect Trump has tasked DOGE with identifying $2 trillion in spending cuts. LeadingAge will be monitoring and engaging in the DOGE’s work, to both provide regulatory relief needed by aging services providers and to ensure resources needed to provide services are not curtailed. Read the opinion piece here (account access required). 

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