CMS plans return to certain pre-COVID standards for long-term care

Heads-up, long-term care facilities. The Biden administration will start phasing out some temporary waivers available under the pandemic public health emergency.

The waivers were put in place to allow nursing homes and other long-term care facilities to respond more nimbly to COVID-19, the Centers for Medicare & Medicaid Services (CMS) said Thursday morning. Facilities are now much better positioned to manage COVID cases, so the agency will push some operations back toward normal.

For example, CMS will nix blanket waivers that allowed facilities to restrict in-person meetings in skilled nursing facilities. Blanket waivers that allowed them to skirt requirements for physicians to make in-person visits to residents—and use telehealth instead—will also be revoked. The agency flagged a group of waivers (PDF) that will expire in 30 days, while others will expire in 60 days.

Recent on-site surveys at long-term care facilities have identified increases in resident complaints that are not related to controlling the spread of COVID-19, such as pressure ulcers or mental health concerns. Relaxed standards thanks to the pandemic may have contributed to these growing issues, CMS said.

In addition, the agency expects long-term care facilities to integrate COVID-mitigation protocols into their existing operations. CMS will help facilities meet regulatory requirements to address patients' physical, mental and psychosocial needs, the agency said.

CMS will still offer some flexibility on compliance, the agency said. For instance, facilities will still be able to secure a temporary waiver for nurse aide certifications if there are proven capacity issues in training and testing programs. And, if COVID-19 cases surge in nursing homes later, CMS will be able to restore blanket waivers available under the public health emergency, the agency said.

“Patient and resident health and safety are top priorities for CMS, and today’s actions are focused on ensuring every nursing home resident is cared for in a safe, high-quality environment,” said CMS Administrator Chiquita Brooks-LaSure in a statement. “We’ve learned a lot from the pandemic over the last two years and are committed to using that knowledge to re-envision the next chapter of health care quality and patient safety and build a stronger health care system.”