Regulations & Reimbursement

Long-term care providers are among the most regulated entities by both the state and federal governments — and, unfortunately, this burden continues to expand. Our new Federal and State Regulations Guide provides LeadingAge PA members with up-to-date information and resources regarding the numerous and varied regulations affecting retirement living communities and other long-term care providers.

The guide provides specific information on senior living regulations, including skilled nursing facilities, assisted living residences, personal care homes, home and community-based services, housing entities and general regulations.

 

Community HealthChoices

Community HealthChoices (CHC) is the Commonwealth’s program delivering Medicaid-funded physical and behavioral health services in addition to long-term services and supports through a capitated, managed care model to older Pennsylvanians and adults with physical disabilities. CHC uses managed care organizations to coordinate the physical health, behavioral health, and long-term service and support needs of participants in order to improve access, efficiency, and quality to qualifying populations. The PA Community HealthChoices program is designed to ensure that individuals get the care they need, no matter where they live.

Below, you’ll find a list of resources to inform you about Community HealthChoices. They can help you understand what the program covers, what it doesn’t cover, how to enroll as a provider, and how to explain it to your residents so they may select a managed care organization.

Still have questions about Community HealthChoices in PA?  Find more information here.

Emergency Preparedness

One important area of retirement living regulation is emergency preparedness. If a fire, flood or other natural disaster strikes, will your community be ready? A new set of requirements, entitled “The New Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers,” is now in effect. Compliance with these retirement living regulations — including documentation of exercises and requisite planning — will be reviewed during annual surveys, and at LeadingAge PA, we want to help you make sure your community is ready. Below, you’ll find a set of resources to help you understand the new senior living regulations and implement them in your organization. 

07/13/2017
This document contains key fields to be included in a sample agreement for a facility’s emergency preparation plan, used to transition residents during an emergency
07/13/2017
Yale New Haven Health System Center for Emergency Preparedness and Disaster Response Emergency Preparedness Final Rule Crosswalk 
07/06/2017
PA Health Care Coalition Contacts 2017 Map  
06/02/2017
Announcement of Advanced Copy of Appendix Z of the SOM: Emergency Preparedness for All Provider and Certified Supplier Types Interpretive Guidance  
03/01/2017
Frequently asked questions and answers on the CMS Final Rule, including all hazards approaches 

Premier Sponsors