On October 4, 2016, The Centers for Medicare and Medicaid Services (“CMS”) released the final rules regarding the requirements of participation for skilled nursing facilities. One of the most significant changes to the regulations is the new abuse reporting requirements. Pursuant to 42 CFR 483.12, skilled nursing facilities must report any allegation of abuse within two hours of the allegation. Additionally, any neglect, mistreatment, exploitation or injuries of unknown source that results in serious bodily injury must also be reported within two hours to the Alabama Department of Public Health. Although serious bodily injury is not defined by the new rules, this term was used in the Elder Justice Act and was defined as “[i]njury involving extreme physical pain; involving substantial risk of death; involving protracted loss or impairment of the function of a bodily member, organ, or mental faculty; or requiring medical intervention such as surgery, hospitalization, or physical rehabilitation.” All other allegations of neglect, mistreatment, exploitation or misappropriation of resident property must be reported within 24 hours. There was no change to the submission of the results of the investigation within five working days. This requirement went into effect on November 28, 2016.