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CMS Issues Blanket Regulatory Waivers to Support COVID-19 Response

The Centers for Medicare & Medicaid Services (CMS) on March 30 issued several regulatory waivers to equip long-term care providers, hospitals and others with flexibility to respond to the COVID-19 pandemic. The waivers address some critical needs where our members have been asking for help, and this news from CMS was a great way for all of us to start the week!  

We are analyzing the waivers to identify where we need clarification or more detail from CMS, and we will work as fast as we can to help you gain immediate support and relief from these waivers.  Meanwhile, here are answers to some initial questions we have received from our care center members.

Where can I find details about the waivers?

The CMS Coronavirus Waivers & Flexibilities webpage is the place to go. There you will find a 26-page summary of the waivers and flexibilities granted to various health care providers across the continuum as well as provider-specific fact sheets tailored for nursing facilities, home health agencies, hospices and other provider and supplier types.

When do the waivers take effect and how long will they last?

The waivers are in place immediately, with a retroactive effective date of March 1, 2020.  The waivers are temporary (not permanent) and will remain in effect all the way through the end of the pandemic emergency. That end date is unknown at this time.

Does my organization have to notify CMS or MDH in order to take advantage of these waivers?

No. These are blanket, nationwide waivers. CMS has stated clearly that these waivers do not require a request to be sent to the 1135waiver@cms.hhs.gov mailbox or that notification be made to any of CMS’s regional offices. We confirmed last week that providers do not need to notify the Minnesota Department of Health (MDH) by letter or email of intention to operate under national, blanket waivers issued by CMS.

Is there anything that will help with our workforce challenges?

Yes!  To assist in addressing staffing shortages due to the COVID-19 pandemic, CMS is waiving the requirements that a setting may not employ anyone as a nursing assistant for longer than four months unless they meet certain training and certification requirements. This means, for example, that someone who has completed training, but cannot test out due to closure of testing centers, could continue working past 120 days, so long as they demonstrate competency in skills and techniques necessary to care for residents’ needs. 

We believe this CMS waiver will also clear a pathway for care centers to employ individuals, temporarily, who have completed an alternative, shortened training program – again, as long as they are competent to provide relevant nursing and nursing related services. 

LeadingAge Minnesota is working actively to finalize a specific, clarifying waiver request to the State of Minnesota to define what such an alternative training pathway could look like. This is a top priority of today’s work (April 1), and expect to have an update for members very soon.

After reading the CMS summary our team still has questions about some of the operational details.  Where can we find answers to those questions?

The LeadingAge Minnesota team has questions, too, so you are not alone! For example, CMS is temporarily waiving the requirements for long-term care facilities to submit staffing data through the Payroll-Based Journal system. A member wrote this morning to ask: (1) Will facilities be required to enter PBJ data for the pandemic time period retroactively? (2) Should facilities continue to track PBJ data during the pandemic as if it were to be submitted later?  We are working with the CMS national team to obtain answers to these sorts of detailed questions, and we will provide information as soon as we receive it. We will share whatever we learn, as soon as we learn it, topic by topic. 

Please email me (jlips@leadingagemn.org) any and all of your questions, and we will add them to our efforts.  Thanks to all of you for what you do everyday!

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