Removal of Temporary Emergency Waivers for Nursing Home

During the Public Health Emergency (PHE), The Centers for Medicare & Medicaid Services (CMS) used a combination of emergency waivers, regulations, and sub-regulatory guidance to offer healthcare providers the flexibility needed to respond to the pandemic. In certain cases, these flexibilities suspended requirements in order to address acute and extraordinary circumstances. Now, CMS is taking steps to continue to protect nursing home residents’ health and safety by announcing guidance that restores certain minimum standards for compliance with CMS requirements. We shared a recent update on the removal of temporary emergency waivers for nursing home, inpatient hospices, ICF/IIDs, and ESRD facilities.

Emergency Waivers for Nursing Home

Restoring these standards will be accomplished by phasing out some temporary emergency declaration waivers that have been in effect throughout the COVID-19 PHE. These temporary emergency waivers were designed to provide facilities with the flexibility needed to respond to the COVID-19 pandemic. CMS is ending specific waivers in two groups: one group of waivers will terminate 30 days from the issuance of this new guidance, and the other group will terminate 60 days from issuance. These timeframes give providers and state agencies time to adjust their operations to the reinstituted requirements.

With steadily increasing vaccination rates for nursing home residents and staff, and with overall improvements seen in nursing homes’ abilities to respond to COVID-19 outbreaks, CMS is taking steps to phase out certain flexibilities that are generally no longer needed to re-establish certain minimum standards while continuing to protect the health and safety of those residing in skilled nursing facilities/nursing facilities (SNFs/NFs). Similarly, some of the same waivers are also being terminated for inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities.

CMS’s recent long-term care (LTC) survey provided insight into issues with resident care that are unrelated to infection control, such as increases in residents’ weight loss, depression, and pressure ulcers. The lack of certain minimum standards, such as training for nurse aides, may be contributing to these issues. By ending some of the temporary waivers, CMS is helping nursing homes to redirect efforts back to meeting the regulatory requirements aimed at ensuring each resident’s physical, mental, and psychosocial needs are met. In addition, CMS expects providers to have integrated practices to address any COVID-19 outbreaks in their normal operations.

CMS will maintain flexibility for certain requirements, such as making temporary waivers available for nurse aides’ certification if there are documented capacity issues in training or testing programs, and CMS will retain the ability until the expiration or termination of the national COVID-19 PHE to issue individual state-based, county-based, or facility-based waivers as needed. Centers for Disease Control & Prevention and CMS data, tracking trends in the number of COVID-19 cases in local communities and nursing homes, provide CMS with the ability to grant waivers in specific situations. For example, if there is a severe outbreak in a facility or geographically distinct group of facilities, CMS can quickly grant waivers to support the facilities’ response to COVID-19. If there is a nationwide surge of nursing home COVID-19 cases in the future, CMS can quickly re-issue national blanket waivers during the PHE.

Outsourcing Skilled Nursing Facility Billing to MBC

MedicalBillersandCoders (MBC) is a leading medical billing company providing complete revenue cycle services. Our team keeps a close watch on revised billing guidelines to ensure accurate insurance reimbursements. To know more about our Emergency Waivers for Nursing Home services, contact us at 888-357-3226

Reference: CMS Returning to Certain Pre-COVID-19 Policies in Long-term Care and Other Facilities