CMS Issues Additional Blanket Waivers
CMS has issued another series of additional blanket waivers that address requirements for:
- Quality Assurance and Performance Improvement (QAPI)
- In-service training for nursing assistants
- Detailed information sharing for discharge planning in long-term care facilities
- Clinical records
- Inspection, testing, and maintenance (ITM) under the physical environment
These waivers are retroactive to March 1 2020 and will be in effect until the end of the national emergency declaration.
The QAPI waiver modifies certain QAPI program requirements to narrow the scope of the program to focus on adverse events and infection control. Specifically in Section 483.75:
- (b) Program design and scope which includes “address all systems of care and management practices:
- (c) Program feedback, data systems, and monitoring
- (d) Program systematic analysis and systematic action
- (e)(3) Performance improvement projects
Nursing assistants are usually required to receive at least 12 hours of in-service training annually. Under the waiver, the deadline for completing this is now the end of the first full quarter after the COVID-19 public health emergency concludes.
CMS is waiving the discharge planning requirement which requires long-term care providers to assist residents and their representatives in selecting a post-acute care provider using data such as standardized patient assessment data, quality measures, and resource use. CMS is maintaining all other discharge planning requirements including the discharge plan.
The requirement for long-term care facilities to provide a resident a copy of their records within two working days when request by the resident has been temporarily amended to give the provider 10 business days.
CMS is waiving certain physical environment requirements for providers (including ICF/IIDs and SNFs/INFs to the extent necessary to permit adjust scheduled inspections, testing and maintenance frequencies, and activities for facility and medical equipment required by the Life Safety Code and Health Care Facilities Code. Not included in the waiver — and thus still in effect – are critical requirements for sprinkler systems, fire extinguishers, elevations with firefighters’ monthly testing, emergency generator testing, and means of egress daily inspections that have undergone construction, repair, or alterations.
The waiver also allows SNFs, NFS, and ICF/IIDs is use facilities that do not have an outside window or outside door in every sleeping room — which is the requirement –or that are not normally used for patients care for temporary patient care or quarantine. Note that federal waivers may not be applicable to state or local Authorities Having Jurisdiction (AHJs).
For a complete CMS explanation: