April 07, 2022

CMS Terminates Most 1135 Waivers for Nursing Homes

BY Jodi Eyigor

CMS released memo QSO-22-15-NH & NLTC & LSC on April 7 to announce that most 1135 waivers related to nursing homes will be ending ahead of the end of the national public health emergency (PHE). While waivers remain in effect at this time for other provider settings including hospitals and critical access hospitals (CAHs), those waivers specific to nursing homes and certain Life Safety Code waivers applicable across multiple settings will be terminated within 30 and 60 days. Most notably, this includes the nurse aide training waivers.

Waivers scheduled to end in 30 days will terminate on May 7, while those scheduled to end in 60 days will terminate on June 6. LeadingAge notes that the national public health emergency is anticipated to be renewed next week, which would extend the PHE for another 90 days into July. Therefore, these waivers are likely being terminated ahead of the end of the public health emergency.

As noted, the nurse aide training waiver is included in CMS’s list of waivers to be terminated. The nurse aide training waiver will terminate in 60 days. Recalling CMS’s previous guidance on transitioning individuals working as temporary nurse aides to certified nurse aides following termination of this waiver, CMS intends that these individuals will have 4 months from the termination of this waiver to satisfy requirements for certification within their states. This means that these individuals must transition within 6 months in order to continue working as nurse aides in the nursing home.

Conspicuously missing from the April 7 memo is the Qualifying Hospital Stay, or 3-day stay. waiver. This waiver, along with the Benefit Period waiver, remains in place at this time and will not be included in the waivers terminated in 30 days or 60 days. This is consistent with CMS’s rationale in the memo to maintain hospital waivers in order to allow flexibility during future surges. We note that while the 3-day stay waiver applies to beneficiaries generally, regardless of COVID status or community levels, CMS has previously cautioned that this waiver is an emergency waiver and is meant to be used when truly needed rather than generally for admission of all individuals receiving Medicare A SNF services. Additionally, providers must ensure that beneficiaries utilizing the 3-day stay waiver otherwise meet criteria for skilled care.

For more information on terminated nursing home waivers, check out the blanket waivers cheat sheet here. LeadingAge will continue to monitor the transition of terminated waivers as well as the status of PHE and waivers that remain in effect at this time.