Ask Proactive – What actions need to be taken in preparation for the end of the Public Health Emergency (PHE)?

What actions need to be taken in preparation for the end of the Public Health Emergency (PHE)?

A:

The COVID-19 national emergency was declared on March 13, 2020. As a result of this, several blanket waivers were put into place. Additions and modifications have been made since the implementation of the 1135 waivers. On January 30^, 2023 the Biden Administration announced that the PHE for COVID-19 will expire as the end of the day on May 11, 2023. Here is a breakdown of the status of various waivers and requirements that should be considered in your preparations:

Waivers ending with the PHE on May 11, 2023:

• • • Qualifying Hospital Stay – A 3-Day inpatient hospital stay will be required for new Part A SNF stays beginning on or after May 12, 2023. The waivers may be used up until May 11^th, so a part A stay beginning on or before May 11th qualifies for the 3 day stay waiver.
    • Benefit Period Waiver – A 60-day period of wellness will again be required to begin a new benefit period. If benefits exhaust on or before May 11^th, the beneficiary is eligible to “re-up” the benefit period under the waiver.
    • Pre-Admission Screening and Resident Review (PASRR) –Completion of a PASRR will be required prior to admission. 42 CFR 483.20(k)
    • Resident Roommates/Grouping –Residents will again have the right to choose roommates and/or refuse relocation. 42 CFR 483.10(e)(5)
    • Resident Transfer and Discharge – Notification of transfer/discharge requirements. 42 CFR 483.10(c)(5); 483.15(c)(3); (c)(5)(i) and (iv), (c)(9), and(d)
    • Medicaid continuous enrollment—research state specific unwinding processes that may impact your beneficiaries; check out Georgetown University’s free tool 50-State Unwinding Tracker – Center For Children and Families (georgetown.edu)
    • Nurse Aide Training – Non-certified nurse aides must complete certification within 4 months of end of PHE (September 11, 2023)

Waivers continuing until May 31, 2024 (unless CMS makes regulatory changes):

• • • Reporting of COVID-19 vaccination status
    • Vaccine Education / Offering

 Waivers continuing until December 31, 2024 (unless CMS makes regulatory changes):

• • • COVID-19 Reporting through NHSN
    • Notification to residents and families of COVID-19 infections
    • Utilization of telehealth

Other Ongoing Requirements:

COVID-19 Testing Requirements

The published rule mandates that for the duration of the PHE, COVID-19 testing is required for individual(s) exhibiting any signs/symptoms of COVID and in response to any positive tests (outbreak testing).  Although the PHE is ending May 11^th, CMS ill continue to require facilities to follow the recommended accepted infection control standards set by the CDC.

Staff Vaccination Mandate

The CDC has recently added COVID-19 vaccines to its routine immunization schedules for kids and adults. Facilities should expect to see changes to the November 2021 CMS interim final rule to reflect CDC recommendations.

https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html#:~:text=However%2C%20as%20part%20of%20the,of%20the%20COVID%2D19%20PHE.

Angie Hamer, RN, RAC-CT
Clinical Consultant

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