The Centers for Medicare & Medicaid Services yesterday issued a final rule representing the first comprehensive rewrite of Medicare and Medicaid quality and safety requirements for long-term care facilities since 1991. According to CMS, the rule finalizes provisions to strengthen patient rights, ensure staff members have the skills and competencies needed to provide patient-centered care, and improve care and discharge planning. The rule also allows dietitians and therapy providers to write orders in their areas of expertise when a physician delegates the responsibility and state licensing laws allow; expands infection prevention and control standards; and requires antibiotic stewardship programs, among other provisions. CMS finalized new regulations focusing on behavioral health services, but removed a proposal to require an in-person evaluation of a resident by a physician, physician assistant, nurse practitioner, or clinical nurse specialist prior to an unscheduled transfer to a hospital. AHA staff are reviewing the final regulations, which will be phased in over a three-year period beginning Nov. 28.