There have been lots of questions swirling around related to the status of the remaining COVID-19 waivers that CMS has issues related to the ongoing Public Health Emergency (PHE), especially related to the 3-day stay waiver. There have been several updates recently that help answer these questions. Please download copies of the appropriate documents linked below to read the full description of the announcements.
1. The most recent information that has been released, dated April 8th, regarding lifting the waivers, can be found at https://www.cms.gov/files/document/qso-21-17-nh.pdf. This document indicates that CMS has decided to lift some of the existing waivers. In summary, CMS indicates the following.
CMS continues to review the need for existing waivers issued in response to the Public Health Emergency (PHE). Over the course of the PHE, nursing homes have developed policies or other practices that we believe mitigates the need for certain waivers.
– Therefore, CMS is announcing it is ending:
o The emergency blanket waivers related to notification of Resident Room or Roommate changes, and Transfer and Discharge notification requirements;
Note: CMS is only ending the waivers at 42 CFR §483.10(e)(6) for providing written notice before a room/roommate change, and at 42 CFR §483.15(c)(4)(ii) for timing of notification of transfer or discharge. The related waivers, which continue to allow facilities to transfer or discharge, and change rooms for the sole purposes of cohorting remain in effect.
o The emergency blanket waiver for certain care planning requirements for residents transferred or discharged for cohorting purposes.
o The emergency blanket waiver of the timeframe requirements for completing and transmitting resident assessment information (Minimum Data Set (MDS).
Note: CMS is not ending the waiver at 42 CFR §483.20(k) related to the Pre-Admission Screening and Annual Resident Review (PASARR) at this time.
o CMS is not ending the current nurse aide waiver which provides a blanket waiver for the nurse aide training and certification requirements at 42 CFR §483.35(d) (except for requirements that the individual employed as a nurse aide be competent to provide nursing and nursing related services at 42 CFR §483.35(d)(1)(i)), specifically to permit nurse aides to work for longer than four months without having completed their training.
2. In addition to lifting some of the waivers last summer, i.e. the PBJ reporting and QRP submission requirements CMS, in the following document also dated April 8, 2021, https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf, CMS indicates that the waivers listed there, excluding the waivers noted in the recent document noted in 1 above, would be effective through the end of the emergency declaration. The 3-day stay waiver continues to be listed there and has not been lifted by other announcements.
3. The COVID PHE emergency declaration was most recently extended by the current HHS administrator, Xavier Becerra, on April 15th at https://www.phe.gov/emergency/news/healthactions/phe/Pages/COVID-15April2021.aspx.
– As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective April 21, 2021, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, that a public health emergency exists and has existed since January 27, 2020, nationwide.
It is noteworthy that for this renewal of the determination that a public health emergency exists that there is no end/renewal date listed, as has been the case with the other such extensions over the last year.