[Federal Register Volume 77, Number 86 (Thursday, May 3, 2012)]
[Rules and Regulations]
[Pages 26183-26184]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-10590]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 51
RIN 2900-AO02
Technical Revisions To Update Reference to the Required
Assessment Tool for State Nursing Homes Receiving Per Diem Payments
From VA
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: This rule updates the reference to the required resident
assessment tool for State homes that receive per diem from VA for
providing nursing home care to veterans. It requires State nursing
homes receiving per diem from VA to use the most recent version of the
Centers for Medicare and Medicaid Services (CMS) Resident Assessment
Instrument/Minimum Data Set (MDS), which is version 3.0. This will
ensure that the standard used to assess veterans is the same as the
standard applicable to Medicare and Medicaid beneficiaries.
DATES: This final rule is effective June 4, 2012.
FOR FURTHER INFORMATION CONTACT: Nancy Quest, Director, Home and
Community Based Services, Geriatrics and Extended Care Services
(10P4G), Veterans Health Administration, Department of Veterans
Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461-6064.
(This is not a toll free number.)
SUPPLEMENTARY INFORMATION: This document adopts as a final rule without
change a proposed rule amending the Department of Veterans Affairs (VA)
regulations. On November 10, 2011, VA published in the Federal Register
(76 FR 70076) a proposal to amend VA regulations to update the
reference to the required resident assessment tool for State homes
providing nursing home care, CMS Resident Assessment
[[Page 26184]]
Instrument/MDS. The MDS is a core set of screening, clinical, and
functional status elements that form the foundation of the
comprehensive assessment for all residents of long term care facilities
certified to participate in Medicare and Medicaid. The MDS is the
standardized assessment instrument in long term care that is used to
identify the health care needs of residents and generate a plan of
care, regardless of source of payment for the individual resident. VA
therefore requires State homes receiving per diem for the provision of
long term care to veterans to use the MDS, and implements this
requirement in 38 CFR 51.110(b)(1)(i).
On October 1, 2010, all CMS certified long term care facilities
were required to update their assessment from MDS 2.0 to MDS 3.0. VA in
turn proposed in a rulemaking that State homes receiving per diem to
provide long term care to veterans use the most up to date version of
MDS. Interested persons were invited to submit comments to the proposed
rule on or before January 9, 2012, and we received no comments.
Therefore, based on the rationale set forth in the proposed rule, VA is
adopting the proposed rule as a final rule without change.
Effect of Rulemaking
Title 38 of the Code of Federal Regulations, as revised by this
rulemaking, represents VA's implementation of its legal authority on
this subject. Other than future amendments to this regulation or
governing statutes, no contrary guidance or procedures are authorized.
All existing or subsequent VA guidance must be read to conform with
this rulemaking if possible or, if not possible, such guidance is
superseded by this rulemaking.
Paperwork Reduction Act
This final rule contains no collections of information under the
Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this regulatory amendment will
not have a significant economic impact on a substantial number of small
entities as they are defined in the Regulatory Flexibility Act, 5
U.S.C. 601-612. This amendment will not directly affect any small
entities, as the State homes that are subject to this rulemaking are
State government entities under the control of State governments. All
State homes are owned, operated, and managed by State governments
except for a small number that are operated by entities under contract
with State governments. These contractors are not small entities.
Therefore, under 5 U.S.C. 605(b), this amendment is exempt from the
initial and final regulatory flexibility analysis requirements of
sections 603 and 604.
Executive Orders 12866 and 13563
Executive Orders 12866 and 13563 direct agencies to assess the
costs and benefits of available regulatory alternatives and, when
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, and other advantages; distributive impacts;
and equity). Executive Order 13563 (Improving Regulation and Regulatory
Review) emphasizes the importance of quantifying both costs and
benefits, reducing costs, harmonizing rules, and promoting flexibility.
Executive Order 12866 (Regulatory Planning and Review) defines a
``significant regulatory action,'' which requires review by the Office
of Management and Budget (OMB), as ``any regulatory action that is
likely to result in a rule that may: (1) Have an annual effect on the
economy of $100 million or more or adversely affect in a material way
the economy, a sector of the economy, productivity, competition, jobs,
the environment, public health or safety, or State, local, or tribal
governments or communities; (2) Create a serious inconsistency or
otherwise interfere with an action taken or planned by another agency;
(3) Materially alter the budgetary impact of entitlements, grants, user
fees, or loan programs or the rights and obligations of recipients
thereof; or (4) Raise novel legal or policy issues arising out of legal
mandates, the President's priorities, or the principles set forth in
this Executive Order.''
The economic, interagency, budgetary, legal, and policy
implications of this regulatory action have been examined and it has
been determined not to be a significant regulatory action under
Executive Order 12866.
Unfunded Mandates
The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C.
1532, that agencies prepare an assessment of anticipated costs and
benefits before issuing any rule that may result in expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100 million or more (adjusted annually for
inflation) in any given year. This rule will have no such effect on
State, local, and tribal governments, or on the private sector.
Catalog of Federal Domestic Assistance Numbers
The Catalog of Federal Domestic Assistance numbers and titles for
the programs affected by this document are 64.005, Grants to States for
Construction of State Home Facilities; 64.009, Veterans Medical Care
Benefits; 64.010, Veterans Nursing Home Care; 64.015, Veterans State
Nursing Home Care; 64.018, Sharing Specialized Medical Resources;
64.019, Veterans Rehabilitation, Alcohol and Drug Dependence.
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. John R.
Gingrich, Chief of Staff, Department of Veterans Affairs, approved this
document on April 24, 2012, for publication.
List of Subjects in 38 CFR Part 51
Administrative practice and procedure, Claims, Day care, Dental
health Government contracts, Grant programs--health, Grant programs--
veterans, Health care, Health facilities, Health professions, Health
records, Mental health programs, Nursing homes, Reporting and
recordkeeping requirements, Travel and transportation expenses,
Veterans.
Dated: April 27, 2012
Robert C. McFetridge,
Director of Regulation Policy and Management, Office of General
Counsel, Department of Veterans Affairs.
For the reasons stated in the preamble, the Department of Veterans
Affairs is amending 38 CFR part 51 as follows:
PART 51--PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES
0
1. The authority citation for part 51 continues to read as follows:
Authority: 38 U.S.C. 101, 501, 1710, 1720, 1741-1743; and as
stated in specific sections.
Sec. 51.110 [Amended]
0
2. Amend Sec. 51.110(b)(1)(i) by removing the phrase ``Version 2.0''
and adding, in its place, ``Version 3.0''.
[FR Doc. 2012-10590 Filed 5-2-12; 8:45 am]
BILLING CODE 8320-01-P