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Statement of Need: Section 6113 of the Affordable Care Act of 2010 (ACA) amends the Act by setting forth certain requirements for LTC facility closures to ensure that, among other things, in the case of a facility closure, any individual who is the administrator of the facility provides written notification of the closure and a plan for the relocation of residents at least 60 days prior to the impending closure or, if the Secretary terminates the facility’s participation in Medicare or Medicaid, not later than the date the Secretary determines appropriate.

Summary of the Legal Basis: Sections 1819(b)(1)(A) of the Social Security Act (the Act) for NFs and 1919 (b)(1)(A) for SNFs state that a skilled nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident. Sections 1819(c)(2)(A) and 1919 (c)(2)(A) of the Act state that, in general, with certain specified exceptions, a nursing facility must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility. Section 6113 of ACA amends section 1128I of the Act by setting forth certain requirements for LTC facility closures.

Alternatives: None. This implements a statutory requirement.

Anticipated Costs and Benefits: The costs associated with the implementation of this rule are related to the efforts made by each facility to develop a plan for closure. The benefits would include the protection of residents’ health and safety and a smooth transition for residents who need to be relocated, as well as their family members and facility staff.

Risks: LTC facility closures have implications related to access, the quality of care, availability of services, and the overall health of residents. Without an organized process for facilities to follow in the event of a nursing home closure, there is a risk to the health and safety of residents.