To: Mass Senior Care Members
From: Tara Gregorio, President
Re: CMS Issues Blanket Regulatory Waivers
Date: March 31, 2020
The Centers for Medicare and Medicaid Services (CMS) has issued several blanket waivers for long term care providers in pages 9-12. These blanket waivers are in effect, with a retroactive effective date of March 1, 2020 through the end of the emergency declaration.
CMS is holding a National Stakeholder Call today, Tuesday, March 31 at 12:00 PM EDT. Participant Dial In: 877-251-0301, Conference ID: 7786289, Audio Webcast: REGISTER
Below is a summary of some of the blanket waivers:
Resident roommates and grouping
CMS is waiving requirements in order to permit grouping or cohorting residents with respiratory illness symptoms and/or residents with a confirmed diagnosis of COVID-19 and separating them from residents who are asymptomatic or tested negative for COVID-19. Specifically, this waives the requirements to provide for a resident to share a room with his or her roommate of choice in certain circumstances, to provide notice and rationale for changing a resident’s room, and to provide for a resident’s refusal a transfer to another room in the facility.
Resident Transfer and Discharge
CMS is waiving some requirements in this area to allow for facilities to transfer or discharge residents to another facility for these three cohorting purposes:
- Transferring residents with symptoms of a respiratory infection or confirmed diagnosis of COVID-19 to another facility that agrees to accept each specific resident, and is dedicated to the care of such residents;
- Transferring residents without symptoms of a respiratory infection or confirmed to not have COVID-19 to another facility that agrees to accept each specific resident, and is dedicated to the care of such residents to prevent them from acquiring COVID-19; or
- Transferring residents without symptoms of a respiratory infection to another facility that agrees to accept each specific resident to observe for any signs or symptoms of a respiratory infection over 14 days.
There are several exceptions for these waived requirements on page 11 of the CMS document.
- These requirements are only waived in cases where the transferring facility receives confirmation that the receiving facility agrees to accept the resident to be transferred or discharged.
- CMS is only waiving the requirement that a facility provide advance notification of options relating to the transfer or discharge to another facility. Otherwise, all requirements related to § 483.10 are not waived.
- CMS is only waiving the requirement for the written notice of transfer or discharge to be provided before the transfer or discharge. This notice must be provided as soon as practicable.
- CMS is only waiving the timeframes for certain care planning requirements for residents who are transferred or discharged for the purposes explained in 1–3 above.
- These requirements are also waived when transferring residents to another facility, such as a COVID-19 isolation and treatment location, with the provision of services “under arrangements,” as long as it is not inconsistent with a state’s emergency preparedness or pandemic plan, or as directed by the local or state health department.
For states receiving the blanket waiver, CMS will allow the state to suspend the PASRR timing requirements for Level I and Level II Assessments. Please note that Massachusetts has not suspended PASRR rules. All NFs (except designated COVID-19 Recovery SNFs) must follow the current PASRR rules. Nursing facilities must continue to follow the current PASRR process.
Minimum Data Set
CMS is providing relief on the time frame requirements for Minimum Data Set assessments and transmission.
Staffing Data Submission
CMS is providing relief to long-term care facilities on the requirements for submitting staffing data through the Payroll-Based Journal system.
CMS is waiving the requirement for physicians and non-physician practitioners to perform in-person visits and to support previously announced flexibilities to allow visits to be conducted, as appropriate, via telehealth options.