CMS Updates Blanket Waivers for Nursing Homes

On April 29, 2020, the Centers for Medicare & Medicaid Services (CMS) updated its list of blanket waivers for the COVID-19 Public Health Emergency (PHE). There are several new waivers that have been added since the last update on April 21, 2020.


Quality Assurance and Performance Improvement (QAPI) Waiver

It seems like Phase 3 of the RoPs was barely underway, including the full implementation of the QAPI regulations, before we ended up in this PHE. CMS has issued a waiver that allows nursing homes to modify their QAPI programs by narrowing the scope of their plans to focus on adverse events and infection control, which, the waiver states, allows providers to focus on the delivery of care that is most related to COVID-19. What regulations are in part of this waiver?

F865

483.75(b)-(d) address the scope and design of the QAPI Program. The existing regulatory requirement mandates that providers address all systems of care. To review the regulatory requirements for F865, you can view CMSCG’s Ftag of the Week for this regulation here.

F867

483.75(e)(3) refers to  the requirement that facilities conduct Performance Improvement Projects (PIPS) as part of their performance improvement activities. These PIPs are supposed to focus on problem-prone areas that have been identified by data collection.

For a review of the requirements under F867 QAPI/QAA Improvement Activities, view CMSCG’s Ftag of the Week for this regulation here.


Nurse Aide In-Service Training

Nurse Aides are required to receive a minimum of 12 hours of Inservice training annually. A blanket waiver issued allows this training to be delayed throughout the COVID-19 PHE until the end of the first full quarter after the PHE has been declared to be over.

For a review of the requirements at F947, view CMSCG’s Ftag of the Week for F947 here.


Discharge Planning Information Sharing

A temporary waiver has been issued related to the requirement that nursing homes assist residents and their representatives with selecting a post-acute provider using standardized data. While all other discharge planning requirements are being retained, this waiver is expected to allow facilities to expedite transfers and discharges of residents.


Clinical Records

Additionally, a temporary waiver has been issued related to the regulatory requirement that nursing homes provide residents with a copy of their records within two working days after they have been requested by the resident. For the duration of the waiver, nursing homes will have ten working days to provide the records instead.

To review the requirements for F842, you can read CMSCG’s Ftag of the Week blog post here.

The updated list of blanket waivers for COVID-19 (updated 4/30/2020) can be accessed on the CMS.gov Current Emergencies webpage.


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