By Patrick Formato, Barbara Phair and Frank Mazzagatti
On April 1, 2020, CMS had a conference call discussing certain federal waivers affecting nursing homes. A summary of the key points of the conference call follows.
1. Transfers of COVID-19 patients
CMS is waiving certain requirements to allow a nursing facility to transfer residents within the facility or to another facility under arrangement with the other facility for the purposes of cohorting and separating residents with and without COVID-19. The transferring facility need not issue a formal discharge in this situation, as it is still considered the provider and should bill Medicare normally for each day of care. The transferring facility is then responsible for reimbursing the other provider that accepted its resident(s) during the emergency period.
2. Training and Certification of Nurse Aides
CMS is waiving the requirements that a facility may not employ anyone for longer than four months unless they meet certain training and certification requirements. This waiver allows nursing homes to temporarily employ individuals who have completed alternative training paths, as long as they are competent to provide relevant nursing and nursing related services. The facility must ensure that the individual is competent to provide services. For example, nursing facilities will be able to employ home health aides to provide services provided the facility ensures that they are competent to provide the relevant services.
3. Resident Groups
CMS is waiving the requirements regarding resident participation in in-person resident groups, considering recommendations of social distancing and limiting social gatherings to prevent the spread of COVID-19.
4. Telehealth services
CMS is waiving the requirement for physicians and other clinicians to perform in-person visits and to allow visits to be conducted via telehealth as is appropriate for the resident. Telehealth services may be provided to new or established patients. The Interim Final Rule and waivers may be accessed at: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers.
5. Diagnostic testing
During the course of the public health emergency for the COVID-19 pandemic, CMS will provide for Medicare payment of a nominal specimen collection fee and associated travel allowance to independent laboratories for collection of specimens related to COVID-19 clinical diagnostic laboratory testing for nursing facility residents.
6. Hospital discharge planning
CMS has relaxed discharge planning requirements for hospitals, such as not requiring the hospital to provide a list of appropriate facilities to patients and family members. CMS expects the hospital to work with the patient to transfer to an appropriate facility that meets his/her needs.
Should you have questions, feel free to contact Patrick Formato, Esq., Barbara Stegun Phair, Esq. or Frank A. Mazzagatti, Esq. or any Abrams Fensterman healthcare attorney at (516) 328-2300.