Nursing homes and other healthcare facilities must have services provided to residents by outside resources in accordance with section 1861(w) of the Act or agreements pertaining to services furnished by outside resources. The arrangements must be specified in writing and the facility must assume responsibility for obtaining services that meet professional standards, as well as ensuring the timeliness of the services. Timeliness is defined as services being completed and results being provided within the timeframe specified in accordance with facility policies and procedures, the medical orders, or professional standards of practice, and facility staff notifying the resident's physician as directed in the medical order. This new letter will impact nursing homes and healthcare facilities by requiring them to make sure that outside resources providing services meet professional standards and that services are provided in a timely manner. They will need to update their policies and procedures to reflect this and ensure that they are meeting the requirements.

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