Nursing homes and other healthcare facilities must ensure that resident bedrooms accommodate no more than four residents, unless they have an approved variance. For facilities that receive approval of construction or reconstruction plans from State and local authorities or are newly certified after November 28, 2016, each resident room must meet the new requirements of no more than two residents per room. In the case of a natural disaster where the Secretary has declared a public health emergency, a waiver of certain requirements may be available under certain conditions. Facilities must also ensure that when residents are transferred or discharged from rooms with more than four residents, beds should be removed from the variance until the number of residents occupying the room does not exceed four. Facilities must also proactively identify and prevent deficiencies most commonly cited during the CMS survey process, such as infection control and accident prevention. This letter will have an impact on nursing homes and other healthcare facilities by requiring them to take action to ensure that resident bedrooms meet the new requirements, remove beds from variance when necessary, and proactively identify and prevent deficiencies.

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