The Centers for Medicare & Medicaid Services (CMS) announced on April 8 that it is ending several emergency regulatory waivers that were designed to give nursing homes flexibility in responding to the COVID-19 pandemic — specifically related to patient transfers and discharges, as well as the timeframe requirements for completing and transmitting a patient’s Minimum Data Set (MDS).
CMS issued a slew of waivers at the start of the pandemic aimed at allowing facilities the flexibility to respond to the ever-changing COVID-19 landscape. Among those waivers were the easing of requirements to provide advance notice before transfers or discharges of residents, including room or roommate changes, according to the update from CMS.
“These waivers allowed facilities to notify residents of a room change or transfer after the transfer has occurred, which helped facilities to swiftly transfer a resident to another unit or facility for cohorting purposes,” the memo to state survey agency directors reads, with the bolding in the original document. “CMS believes nursing homes have developed practices by now that have made them able to efficiently cohort residents and provide the required notice in advance.”
Nursing homes now again must provide 30 days of advance notice, “or as soon as practicable before the transfer or discharge of a resident,” according to the memo, with the emphasis in the document. They also have to provide such notification before a change of roommate.
However, CMS noted that the waiver being ended is for providing written notice before a room or a roommate change, and for the timing of the notification of a transfer or change.
“The related waivers, which continue to allow facilities to transfer or discharge, and change rooms for the sole purposes of cohorting, remain in effect,” the agency noted.
Nursing homes are also now required to complete and submit MDS assessments under the old regulations, since most facilities have been able to do this in a timely way, CMS said.
The agency did not end a current waiver for nurse aide training and certification, but it did add that it was clarifying how federal rules can be applied to nurse aides working under that particular exemptions — which allows facilities to employ individuals in a nurse aide role beyond four months even if they have not completed a state-approved Nurse Aide Training and Competency Evaluation program.
“Though this waiver is not being terminated at this time, we are advising stakeholders that the four-month regulatory timeframe will be reinstated when the blanket waiver ends and will start at that time,” CMS said. “In other words, nurse aides will have the full four month period starting from the end of the blanket waiver to successfully complete the required training and certification, regardless of the amount of time worked during the time the waiver was in effect.”
That said, the agency stressed that states and nurse aides should not lose sight of the need to complete the certification and training.
“However, though nurse aides will have up to four months from the end of the blanket waiver to complete the required training and certification, we strongly encourage states and nurse aides to explore ways to complete all the training and certification requirements as soon as possible,” CMS said.