CMS To End COVID-19 Waivers for NFs, ICF/IIDs, Inpatient Hospices on May 7 or June 6, 2022 (QSO-22-15-NH & NLTC & LSC)

April 13, 2022

The Centers for Medicare & Medicaid Services has issued QSO-22-15-NH & NLTC & LSC. The memo will end COVID-19 emergency declaration blanket waivers for nursing facilities, skilled nursing facilities, ICF/IIDs, and inpatient hospices in two phases:

  • 30 days from April 7, 2022
  • 60 days from April 7, 2022

The following waivers will end May 7, 2022:

  • Resident Groups in SNF/NFs - 42 CFR §483.10(f)(5)
  • Physician Delegation of Tasks in SNFs - 42 CFR §483.30(e)(4)
  • Physician Visits in in SNF/NFs - 42 CFR §483.30(c)(3)
  • Physician Visits in Skilled Nursing Facilities/Nursing Facilities - 42 CFR §483.30
  • Quality Assurance and Performance Improvement (QAPI) in SNF/NFs – 42 CFR §483.75(b)–(d) and (e)(3)
  • Detailed Information Sharing for Discharge Planning in SNF/NFs - 42 CFR §483.21(c)(1)(viii)
  • Clinical Records in SNF/NFs - 42 CFR §483.10(g)(2)(ii)

The following waivers will end June 6, 2022:

  • Training and Certification of Nurse Aides for SNF/NFs (42 CFR §483.35(d)) - a SNF or NF may not employ anyone for longer than four months unless they met specific training and certification requirements.

PLEASE NOTE: Nurse aides will have until October 6, 2022 to successfully complete the required training and certification,

regardless of the amount of time worked during the time the waiver was in effect. Nurse aides who want to use SNF/NF work training and experience gained during the COVID-19 public health emergency to count toward nurse aide certification must follow the process outlined in Provider Letter 2021-19 - Certification Process for Nurse Aides Training and Working Under a Waiver.

  • Physical Environment for SNF/NFs - 42 CFR §483.90
  • Facility and Medical Equipment Inspection, Testing & Maintenance (ITM) for Inpatient Hospice, ICF/IIDs and SNFs/NFs – 42 CFR §§418.110(c)(2)(iv), 483.470(j), and 483.90
  • Life Safety Code (LSC) and Health Care Facilities Code (HCFC) ITM for Inpatient Hospice, ICF/IIDs and SNFs/NFs - 42 CFR §§ 418.110(d)(1)(i) and (e), 483.470(j)(1)(i) and (5)(v), and 483.90(a)(1)(i) and (b)
  • Outside Windows and Doors for Inpatient Hospice, ICF/IIDs and SFNs/NFs – 42 CFR §§418.110(d)(6), 483.470(e)(1)(i), and 483.90(a)(7)
  • Life Safety Code for Inpatient Hospice, ICF/IIDs, and SNFs/NFs - 42 CFR §§418.110(d), 483.470(j), and 483.90(a)
  • Paid Feeding Assistants for SNF/NFs - 42 CFR §§483.60(h)(1)(i) and 483.160(a)
  • In-Service Training for SNF/NFs – 42 CFR §483.95(g)(1)

Read the CMS memo details.