Removal of Temporary Emergency Waivers for Nursing Home
                     
Removal of Temporary Emergency Waivers for 
Nursing Home
During the Public Health Emergency (PHE), The Centers for Medicare & Medicaid Services (CMS) used a 
combination of emergency waivers, regulations, and sub-regulatory guidance to offer healthcare providers the 
flexibility needed to respond to the pandemic. In certain cases, these flexibilities suspended requirements in 
order to address acute and extraordinary circumstances. Now, CMS is taking steps to continue to protect 
nursing home residents’ health and safety by announcing guidance that restores certain minimum standards for 
compliance with CMS requirements. We shared a recent update on the removal of temporary emergency 
waivers for nursing home, inpatient hospices, ICF/IIDs, and ESRD facilities.
Emergency Waivers for Nursing Home
Restoring these standards will be accomplished by phasing out some temporary emergency declaration waivers 
that have been in effect throughout the COVID-19 PHE. These temporary emergency waivers were designed to 
provide facilities with the flexibility needed to respond to the COVID-19 pandemic. CMS is ending specific 
waivers in two groups: one group of waivers will terminate 30 days from the issuance of this new guidance, and 
the other group will terminate 60 days from issuance. 
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Removal of Temporary Emergency Waivers for 
Nursing Home
These timeframes give providers and state agencies time to adjust their operations to the reinstituted 
requirements.
With steadily increasing vaccination rates for nursing home residents and staff, and with overall improvements 
seen in nursing homes’ abilities to respond to COVID-19 outbreaks, CMS is taking steps to phase out certain 
flexibilities that are generally no longer needed to re-establish certain minimum standards while continuing to 
protect the health and safety of those residing in skilled nursing facilities/nursing facilities (SNFs/NFs). Similarly, 
some of the same waivers are also being terminated for inpatient hospices, intermediate care facilities for 
individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities.
CMS’s recent long-term care (LTC) survey provided insight into issues with resident care that are unrelated to 
infection control, such as increases in residents’ weight loss, depression, and pressure ulcers. The lack of certain 
minimum standards, such as training for nurse aides, may be contributing to these issues. By ending some of 
the temporary waivers, CMS is helping nursing homes to redirect efforts back to meeting the regulatory 
requirements aimed at ensuring each resident’s physical, mental, and psychosocial needs are met. In addition, 
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Removal of Temporary Emergency Waivers for 
Nursing Home
CMS expects providers to have integrated practices to address any COVID-19 outbreaks in their normal 
operations.
CMS will maintain flexibility for certain requirements, such as making temporary waivers available for nurse 
aides’ certification if there are documented capacity issues in training or testing programs, and CMS will retain 
the ability until the expiration or termination of the national COVID-19 PHE to issue individual state-based, 
county-based, or facility-based waivers as needed. Centers for Disease Control & Prevention and CMS data, 
tracking trends in the number of COVID-19 cases in local communities and nursing homes, provide CMS with 
the ability to grant waivers in specific situations. For example, if there is a severe outbreak in a facility or 
geographically distinct group of facilities, CMS can quickly grant waivers to support the facilities’ response to 
COVID-19. If there is a nationwide surge of nursing home COVID-19 cases in the future, CMS can quickly re-issue 
national blanket waivers during the PHE.
Outsourcing Skilled Nursing Facility Billing to MBC
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Removal of Temporary Emergency Waivers for 
Nursing Home
MedicalBillersandCoders (MBC) is a leading medical billing company providing complete revenue cycle 
services. Our team keeps a close watch on revised billing guidelines to ensure accurate insurance 
reimbursements. To know more about our Emergency Waivers for Nursing Home services, contact us at 
[email protected]/ 888-357-3226
Reference: CMS Returning to Certain Pre-COVID-19 Policies in Long-term Care and Other Facilities
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