If we have a new admission on or prior to May 11th using the QHS waiver, what happens when they require a hospital stay?



John Kane addressed this during the Open Door Forum (ODF) on March 2nd. The full transcript for this ODF is located under the Skilled Nursing Facility (SNF)/Long Term Care (LTC), Open Door Forum section of the Open Door Forum Podcasts and Transcripts webpage.

“… if you have a stay that begins under Medicare utilizing the qualifying hospital stay waiver and it goes beyond May 12 and then there is an interruption in that stay where the person returns to their Medicare coverage during the interruption window at the same facility, again meaning it’s an interrupted stay, then that stay can continue on the way any other interrupted stay would occur. However, if the person does not return to the same facility or they do not return within the interruption window, meaning that it would be a new Medicare stay when the person returns, then that new Medicare stay would be under all of the typical provisions and rules of a regular SNF stay, meaning that they would require a qualifying hospital stay.”

The FAQ for CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency was also recently updated. Question 12 addresses the QHS waiver for SNF.


Stacy Baker, OTR/L, CHC, RAC-CT
Director of Audit Services

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