Home Health & Hospice Week

OT, nurses, aides affected.

Home health and hospice agencies are getting a bit more regulatory leeway from Medicare to battle the COVID-19 pandemic.

On April 10, the Centers for Medicare & Medicaid Services issued its latest round of regulatory waivers, including one for HHAs and two for hospices, that apply immediately:

• HHA: CMS is waiving the requirement that occupational therapists may only perform the initial and comprehensive assessment if OT is the service that establishes eligibility, the agency says in a fact sheet about its waivers.“This temporary blanket modification allows OTs to perform the initial and comprehensive assessment for all patients receiving therapy services as part of the plan of care, to the extent permitted under state law, regardless of whether occupational therapy is the service that establishes eligibility.” This change allows “home health services to start sooner and free[s] home-health nurses to do more direct patient care,” CMS says in an accompanying release. The change “should greatly expand what the service can do,” said a CMS official in the agency’s April 14 COVID-19 call for home health and hospice providers.
• Hospice: CMS is temporarily allowing hospices to utilize pseudo patients instead of actual patients for competency testing of hospice aides for those tasks that must be observed being performed on a patient, CMS notes in the fact sheet. A pseudo patients can be “a person trained to participate in a role-play situation or a computer-based mannequin device,” for example, CMS says. The change will allow nurses and aides to spend more time with patients, CMS says in the release. The waiver will speed the testing process and help bring new aides online faster, the CMS official said in the April 14 call.
• Hospice: CMS is waiving the requirement that each hospice aide receives 12 hours of in-service training in a 12-month period. This allows aides and the RNs who teach in-service training to spend more time delivering direct patient care, CMS says in the fact sheet. Under the waiver, hospices won’t have to pull nurses or aides away from patient care to do training, the CMS official said in the call.CMS does expect regular training to resume when the public health emergency is declared over, she pointed out.

“It’s all hands on deck during this crisis,” CMS Administrator Seema Verma says in the release.“All frontline medical professionals need to be able to work at the highest level they were trained for.”

Note: The fact sheet that includes info on all waivers to date is at www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf.