The Centers for Medicare & Medicaid Services (CMS) has extended 1135 Disaster Waivers to multiple states in the wake of Hurricane Helene, including Florida, Georgia, North Carolina, South Carolina and Tennessee.
CMS can issue waivers under Section 1135 of the Social Security Act to help providers and beneficiaries during disasters and emergencies such as hurricanes, when:
- The President declares a disaster or emergency under the Stafford Act or National Emergencies Act
- The HHS Secretary declares a Public Health Emergency under Section 319 of the Public Health Service Act
- Waivers can:
- Ensure that health care items and services are available
- Reimburse and exempt providers from sanctions
- Allow people with Medicare to receive replacements for damaged durable medical equipment, prosthetics, orthotics, and supplies
Multiple blanket waivers and other flexibilities are in effect through the end of the Hurricane Helene Public Health Emergency. It’s important to note that blanket waivers DO NOT need to be submitted via the CMS 1135 Waiver Portal or via notification to the CMS Survey & Operations Group and are applied automatically by surveyors.
Waivers and flexibilities most critical to Long-Term Care Facilities and Skilled Nursing Facilities (SNFs) and/or Nursing Facilities (NFs) include:
- Reporting Minimum Data Set (MDS). CMS is modifying the requirements at 42 CFR §483.20(b)(2) to provide relief to SNFs on the timeframes in which they must conduct a comprehensive assessment and collect MDS data. However, CMS is not waiving the requirements for facilities to conduct the assessment and collect MDS data at 42 CFR 483.20(b)(1).
- Waive Pre-Admission Screening and Annual Resident Review (PASARR). CMS is waiving 42 CFR § 483.20(k), which will allow nursing homes to admit new residents who have not received Level 1 or Level 2 Preadmission Screening. Level 1 assessments may be performed post admission. Please note, on or before the 30th day of admission, new patients admitted to nursing homes with a mental illness (MI) or intellectual disability (ID) should be referred promptly by the nursing home to the State PASARR program for Level 2 Resident Review.
- 3-Day Prior Hospitalization. Using the authority under Section 1812(f) of the Act, CMS may cover SNF stays without a 3-day prior inpatient hospitalization. For certain beneficiaries who recently exhausted their SNF benefits, it also authorizes a one-time renewal of SNF coverage without first having to start a new benefit period (this portion of the waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from starting or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances).
- Physician Visits in Skilled Nursing Facilities/Nursing Facilities. CMS is waiving the requirement in 42 CFR 483.30 for physicians and non-physician practitioners to perform in person visits for nursing home residents and is allowing visits to be conducted, as appropriate, via telehealth options.
- Physical Environment. CMS is waiving requirements under 42 CFR 483.90 to temporarily allow for rooms in a long-term care facility not normally used as a resident’s room, to be used to accommodate beds and residents for resident care in emergencies and situations needed to help with surge capacity. This can be done so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan, or as directed by the local or state health department.
ASPRs full list of current waivers can be found here. Please see additional links to CMS’ 1135 Available Waiver list for Florida and Georgia, South Carolina and Tennessee, and North Carolina.
%20(1).svg)
