The idea that the requirement for culture change to person-centered care “expires” stems from a misunderstanding of a regulatory deadline. The mandate for long-term care and nursing facilities to adopt person-centered care is a permanent requirement, not a temporary measure with a sunset date. This transition was required by the Centers for Medicare & Medicaid Services (CMS) as part of a significant update to the Requirements of Participation (RoPs) for nursing homes. The date often mistaken for an expiration was the final deadline for facilities to complete the required culture change and fully implement the new standards. The federal government established this mandate to fundamentally shift the focus of care from an institutional, task-oriented model to one that respects the individual resident’s life and preferences.
Foundational Principles of Person-Centered Care
Person-Centered Care (PCC) is a philosophy that shifts the traditional institutional structure toward promoting the autonomy and dignity of residents. It focuses on the individual’s history, habits, and preferences, ensuring these elements guide the planning and delivery of daily services. This framework moves away from a one-size-fits-all approach to care, instead prioritizing the resident as an active partner in their own well-being.
The core components of this philosophy revolve around honoring personal choice, promoting independence, and maintaining a high quality of life. This includes allowing residents to choose their wake-up and bedtime routines, the timing of their meals, and their preferred daily activities, rather than adhering to a rigid facility schedule. By involving the resident in decision-making, care plans become personalized and tailored to their unique values, goals, and experiences.
The Regulatory Timeline for Full Implementation
The requirement for person-centered care is legally rooted in the 2016 revisions to the Centers for Medicare & Medicaid Services (CMS) Requirements of Participation (RoPs) for Long-Term Care Facilities (42 CFR Part 483). These revisions represented the most extensive update to federal nursing home regulations in decades, mandating a complete cultural shift. Implementation was strategically phased over three years to allow facilities time to adapt their operations, staffing, and documentation systems.
Phase 1 of the new requirements took effect in November 2016, introducing foundational elements and initial training mandates. Phase 2 followed in November 2017, focusing on complex systems like behavioral health and pharmacy services. The final phase, Phase 3, had its completion deadline on November 28, 2019.
This November 2019 deadline marked the point where facilities were required to have fully integrated person-centered care into all operations, including comprehensive care planning (F-Tag F656) that must be culturally competent and trauma-informed. The deadline signified that the transition to this new care model was complete and subject to full regulatory enforcement. The mandate is a permanent, ongoing condition for participation in Medicare and Medicaid programs.
Current Compliance and Survey Expectations
Compliance with person-centered care standards has been an ongoing requirement since the final deadline, assessed regularly through unannounced state and federal surveys. Surveyors use the federal State Operations Manual Appendix PP, which contains specific F-Tags, to evaluate adherence to the RoPs. For example, F-Tag F656 addresses the development and implementation of the Comprehensive Person-Centered Care Plan, while F550 relates to Resident Rights.
Inspectors assess whether facilities demonstrate a shift from an institutional mindset to one that promotes resident choice and quality of life in areas like activities, dining, and daily routines. Compliance is measured by observing staff interactions, reviewing resident records, and interviewing residents and their families to confirm that care is individualized. Facilities must show evidence of Continuous Quality Improvement (CQI) related to person-centered care. Failure to maintain these standards can result in deficiencies, recorded under the corresponding F-Tags, leading to sanctions, financial penalties, or loss of Medicare and Medicaid funding.