On April 8, 2021, the Centers for Medicare & Medicaid issued a policy memo announcing the termination of several 1135 waivers related to resident transfers, care plans, and assessments in nursing homes, effective May 10, 2021. Luckily, the 3-day inpatient stay waiver remains in effect. The details of the terminated waivers are below. All other federal blanket waivers, including all hospital-related waivers, will remain in effect until the national public health emergency declaration ends.
- Transfer and Discharge Notification Requirements (42 CFR 483.15(c)(4)(ii)) – Nursing homes must resume compliance with the requirement to provide notice to a resident and resident representative 30 days in advance or as soon as practicable, prior to transfer or discharge.
- Resident Room or Roommate Changes (42 CFR 483.10(e)(6)) – Nursing homes must provide notice to residents prior to change of room or roommate.
Note: The related waivers, which continue to allow facilities to transfer or discharge and change rooms for the sole purposes of cohorting, remain in effect.
- Care Plan Requirements (42 CFR 483.21(a)(1)(i), (a)(2)(i), and (b)(1)(i)) – Nursing homes must again complete baseline care plans within 48 hours of admission and comprehensive care plans within seven days of admission.
- Minimum Data Set (MDS) Assessments (42 CFR 483.20) – Nursing homes must resume compliance with timely completion and submission of all required MDS assessments.
Note: At this time CMS is not ending the waiver at 42 CFR §483.20(k) related to the Pre-Admission Screening and Annual Resident Review (PASARR).
- Training and Certification of Nurse Aides (42 CFR §483.35(d)) – This blanket waiver is NOT being terminated at this time; however, CMS is advising that the four-month regulatory timeframe will be reinstated when the blanket waiver ends. Under the current waiver, facilities may employ individuals beyond four months in a nurse aide role even though they might not have completed a state approved 75-hour Nurse Aide Training and Competency Evaluation Programs (NATCEP). It will be up to each state to determine whether some of the time worked by the nurse aides during the pandemic will count towards the 75-hour training requirement.
A link to the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers can be found here and a link to the April 8 Policy Memo, which details the reasoning behind the terminations, can be found here.
If you have any questions about the waivers or require assistance, please contact an Advis expert and call (708) 478-7030.
Published: April 15, 2021