In response to the COVID-19 Public Health Emergency and under the Secretary’s authority set out at section 1135 of the Social Security Act, CMS enacted several temporary emergency declaration blanket waivers which were intended to provide healthcare providers with extra flexibilities required to respond to the COVID-19 pandemic.
CMS continues to evaluate the impact of these waivers on patient care and providers along with corresponding data. While the waivers of regulatory requirements have provided flexibility in how nursing homes may operate, they have also removed the minimum standards for quality that help ensure residents’ health and safety are protected.
Please review the entire CMS Memo and begin planning for these blanket waivers to expire. Some waivers end 30 days from publication of this memo, some end 60 days from publication of this memo
Recent onsite long-term care (LTC) survey findings have 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 into their normal operations.
“Patient and resident health and safety are top priorities for CMS, and today’s actions are focused on ensuring every nursing home resident is cared for in a safe, high-quality environment,” said CMS Administrator Chiquita Brooks-LaSure. “We’ve learned a lot from the pandemic over the last two years and are committed to using that knowledge to re-envision the next chapter of health care quality and patient safety and build a stronger health care system.”
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.
.Details can be found in the Quality, Safety, and Oversight (QSO) memo.