cms blanket waivers update

On April 7, 2022, CMS issued a memorandum that ended specific waivers for skilled nursing facilities/nursing facilities (SNFs/NFs), inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) and end-stage renal disease (ESRD) facilities. CMS will end the specific waivers in two groups, the first 60 days from the issuance of the memorandum and the second 30 days from the issuance of the memorandum.

CMS notes that they targeted these specific waivers as they continue to review the need for existing emergency blanket waivers issued in response to COVID-19. They believe that these facilities have developed policies or other practices that mitigate the need for the specific waivers. Also noted, they targeted waivers that should be restored to address the risks to resident health and safety that are not related to infection control. Applicable waivers will remain in effect for hospitals and critical access hospitals (CAHs).

Blanket Waivers Ending 30 days from publication of Memorandum:

1. Resident Groups – 42 CFR §483.10(f)(5)
2. Physician Delegation of Tasks in SNFs – 42 CFR §483.30(e)(4)
3. Physician Visits – 42 CFR §483.30(c)(3)
4. Physician Visits in Skilled Nursing Facilities/Nursing Facilities – 42 CFR §483.30
5. Quality Assurance and Performance Improvement (QAPI) – 42 CFR §483.75(b)–(d) and (e)(3)
6. Detailed Information Sharing for Discharge Planning for Long-Term Care (LTC) Facilities – 42 CFR §483.21(c)(1)(viii)
7. Clinical Records – 42 CFR §483.10(g)(2)(ii)

Blanket Waivers Ending 60 days from publication of Memorandum:

1. Physical Environment for SNF/NFs – 42 CFR §483.90
2. Equipment Maintenance & Fire Safety Inspections for ESRD facilities – 42 CFR §494.60(b) and(d)
3. Facility and Medical Equipment Inspection, Testing & Maintenance (ITM) for Inpatient Hospice, ICF/IIDs and SNFs/NFs – 42 CFR §§418.110(c)(2)(iv), 483.470(j), and 483.90
4. Life Safety Code (LSC) and Health Care Facilities Code (HCFC) ITM for Inpatient Hospice, ICF/IIDs and SNFs/NFs – 42 CFR §§ 418.110(d)(1)(i) and (e), 483.470(j)(1)(i) and (5)(v), and 483.90(a)(1)(i) and (b)
5. Outside Windows and Doors for Inpatient Hospice, ICF/IIDs and SFNs/NFs – 42 CFR §§418.110(d)(6), 483.470(e)(1)(i), and 483.90(a)(7)
6. Life Safety Code for Inpatient Hospice, ICF/IIDs, and SNFs/NFs – 42 CFR §§418.110(d), 483.470(j), and 483.90(a)
7. Paid Feeding Assistants for LTC facilities: 42 CFR §§483.60(h)(1)(i) and 483.160(a)
8. In-Service Training for LTC facilities – 42 CFR §483.95(g)(1)
9. Training and Certification of Nurse Aides for SNF/NFs – 42 CFR §483.35(d) (Modification and Conditional Termination)

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More information

Specific waivers that will be ending:

• https://www.cms.gov/files/document/qso-22-15-nh-nltc-lsc.pdf

Current emergency blanket waivers in effect due to the COVID-10 pandemic:

• https://www.cms.gov/files/document/covid-19-emergency-declaration-waivers.pdf
• https://www.cms.gov/coronavirus-waivers