Comment by May 20 to tell CMS not to weaken nursing facility rules that keep people with disabilities in their homes and communities and out of nursing facilities vulnerable to the COVID-19 pandemic

The Preadmission Screening and Resident Review (PASRR) is a federal rule to help keep people with disabilities from being unnecessarily placed in Medicaid-funded nursing facilities and to help nursing facility residents transition back to the community. PASRR has been an important tool to further the civil rights of people with disabilities and help states comply with the Supreme Court’s Olmstead decision. CPR has brought lawsuits enforcing these rules in several states across the country, and we know how important it is to have a strong PASRR regulation that promotes community integration.
 

Keeping people out of nursing facilities is especially important now, with COVID-19 ravaging nursing facilities around the country. But right now, in the middle of this pandemic, the Centers for Medicare and Medicaid Services (CMS) is proposing a rule that would weaken PASRR, making it easier for people to be admitted to nursing facilities and harder for them to transition from these facilities back to the community. We've made it easy for you or your organization to comment now, using template comments included below. Comments from individuals can also be submitted through the online portal put together by our friends at NDRN, which you can find here.

The proposed rule encourages states to bypass preadmission screening and evaluation of community options prior to admission to a nursing facility. Preadmission screening and evaluation is necessary under normal circumstances because once someone is admitted to a nursing facility, that person is much less likely to return to their community quickly and at higher risk of long-term institutionalization. In this pandemic, however, it takes on a new level of importance. Unnecessary admissions will lead to needless exposure to COVID-19, at a minimum traumatizing those individuals and their families and, for many, leading to avoidable deaths.

The proposed rule would also make it harder for people to transition from nursing facilities to the community. The rule would limit the services that nursing facilities have to provide once someone is admitted. Without these specialized services, people will lose basic skills, and have no opportunity to learn new skills, that would make it easier for them to transition back to their communities. The rule would also only require that nursing facility residents receive some undefined “information about community options;” it doesn’t ensure that people have enough information to adequately understand their options and make an informed choice about remaining in the facility or returning to the community.

The proposed rule would allow states to avoid any responsibility for community integration if there is not a “currently available community option” -- even if everyone agrees the person could be best served in the community. PASRR was intended to promote the transition from institutional care to community alternatives whenever appropriate; weakening that commitment now is not only contrary to federal law, but also endangers people’s health and safety.

We’ve created comments for Protection and Advocacy agencies and other advocacy organizations. Individuals can also submit comments using this template or through this portal put together by NDRN. We need you to oppose the Administration's efforts to weaken PASRR and let CMS know that while these proposed changes would always be harmful, it would be especially dangerous to implement them in the midst of the coronavirus crisis. Please urge CMS to reconsider and revise the proposal rule and reissue it for public comment. This simply is not the time to make it easier to admit, and harder to discharge, individuals with disabilities to nursing facilities.

Comments can be submitted here or through the portal mentioned above and are due Wednesday, May 20, 2020 at 11:59PM ET. We also have written instructions for first time commenters who may be unfamiliar with the process that you can find here.