Regulatory Reminders! CMS Eliminates Key COVID-19 Waivers

Wow! 2 Regulatory Reminders in two days. CMS has been busy!

You may be wondering how long CMS will allow many of the COVID-19 waivers will last. Well wonder no longer. Today, CMS issued QSO-22-15-NH. In this memo, CMS has initiated a 30 and 60 day timeline for the phase out of some of the COVID-19 waivers that affect Nursing Homes.

The waivers that will be phased out, “…have been identified as those requirements that should be restored to address the risks to resident health and safety that are not related to infection control.”  CMS has indicated that they believe that, “…at this time, nursing homes should be able to adjust their operations to meet these regulatory requirements, while also addressing any issues related to COVID-19.”     

3 Day Stay Waiver?

I know what you are asking and, No, CMS has not eliminated the 3-day stay waiver or the 100-day benefit waiver with this announcement. The current PHE extension ends on April 16th and CMS has indicated that they will give at least a 60 day forewarning before they eliminate these important waivers.   

Here is a rundown of the waivers related to SNFs, and the timelines for phase out addressed in today’s memo. You may read more detail in the attached memo and at the CMS COVID-19 Waivers website in the document titled, “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers

Emergency Declaration Blanket Waivers Ending for SNF/NFs 30 Days from Publication of this Memorandum:

  • Resident Groups – 42 CFR §483.10(f)(5)
  • Physician Delegation of Tasks in SNFs – 42 CFR §483.30(e)(4)
  • Physician Visits – 42 CFR §483.30(c)(3)
  • Physician Visits in Skilled Nursing Facilities/Nursing Facilities – 42 CFR §483.30
  • Quality Assurance and Performance Improvement (QAPI) – 42 CFR §483.75(b)–(d) and (e)(3)
  • Detailed Information Sharing for Discharge Planning for Long-Term Care (LTC) Facilities – 42 CFR §483.21(c)(1)(viii)
  • Clinical Records – 42 CFR §483.10(g)(2)(ii)

Emergency Declaration Blanket Waivers For Various Provider-Types Ending 60 Days from Publication of this Memorandum:

  • Physical Environment for SNF/NFs – 42 CFR §483.90
  • Facility and Medical Equipment Inspection, Testing & Maintenance (ITM) for Inpatient Hospice, ICF/IIDs and SNFs/NFs – 42 CFR §§418.110(c)(2)(iv), 483.470(j), and 483.90
  • Life Safety Code (LSC) and Health Care Facilities Code (HCFC) ITM for Inpatient Hospice, ICF/IIDs and SNFs/NFs – 42 CFR §§ 418.110(d)(1)(i) and (e), 483.470(j)(1)(i) and (5)(v), and 483.90(a)(1)(i) and (b)
  • Outside Windows and Doors for Inpatient Hospice, ICF/IIDs and SFNs/NFs – 42 CFR §§418.110(d)(6), 483.470(e)(1)(i), and 483.90(a)(7)
  • Life Safety Code for Inpatient Hospice, ICF/IIDs, and SNFs/NFs – 42 CFR §§418.110(d), 483.470(j), and 483.90(a)
  • Paid Feeding Assistants for LTC facilities: 42 CFR §§483.60(h)(1)(i) and 483.160(a)
  • In-Service Training for LTC facilities – 42 CFR §483.95(g)(1)
  • Training and Certification of Nurse Aides for SNF/NFs – 42 CFR §483.35(d)

COVID-19, at least as a Public Health Emergency causing these waivers to be initiated seems to be waning. It will not be surprising at all to see more waivers phased out in the near future. Stay Tuned!