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CMS 1135 Waiver Extended (Again!)

On Monday, October 18, 2021, the Secretary of Health and Human Services, Xavier Becerra, renewed the Public Health Emergency declaration, which includes access to waiver or modification of requirements under Section 1135 of the Social Security Act, for another 90 days. The new expiration date is set for January 16, 2022. Should the PHE end prior to the expiration date, a 60-day notice will be required.

As you read this information, you may find yourself experiencing a bit of déjà vu! Rightfully so, as this renewal marks the seventh extension of the Public Health Emergency since its original declaration on January 31, 2020.

While usage of the Section 1135 waiver may feel like “old news,” the need for resident advocacy + purposeful, strategic usage is as relevant as ever! Hospitals and Home Health Agencies are looking for trusted SNF partners as they experience a significant uptick in referral volume + resident complexities. Learn more about the shift towards home-based care services + associated legislation HERE.

Now is the time to show your value as a vital part of the continuum of care! Below are a few key points to keep in mind as we continue to navigate the ever-changing spectrum of healthcare.

  • Complete daily team meetings to discuss any changes in resident conditions across the spectrum of care. Be sure to include a discussion of why residents may meet the criteria for skilled care.
  • Continue frequent touchpoints with upstream hospitals in your area, emphasizing your ability to admit residents directly from the ER or without a qualifying hospital stay. Do hospital discharge planners know of your clinical capabilities?
  • Consider participation in an Emergency Department diversion program.
  • Engage with downstream partners such as community physicians, specialty clinics + home health agencies. Do they know you can directly admit residents in need of skilled nursing services?
  • Residents do NOT have to have a diagnosis of COVID-19 to utilize the 3 Day Waiver; however, residents MUST meet the criteria for skilled care. For additional details, please reference our CMS Waiver Skilling Guide here.
  • Be an advocate for your residents who meet the criteria for skilled care! They are eligible and entitled to utilize their Medicare benefits.

If you have any additional questions, please don’t hesitate to contact us here, or by emailing info@healthpro-heritage.com

Please see the formal PHE renewal statement: here.