Tuesday, December 1, 2020
9 months into the Public Well being Emergency (“PHE”), with COVID-19 circumstances surging throughout the nation, the Facilities for Medicare & Medicaid Companies (“CMS”) has introduced two new methods to reinforce hospital capability that target nurse staffing. First, CMS is increasing its Hospitals With out Partitions program so as to add a brand new ‘Acute Hospital Care at Dwelling’ initiative that permits for extra versatile nurse staffing. Second, CMS is permitting flexibility for nurse staffing for Ambulatory Surgical procedure Facilities (“ASCs”) which can be enrolled as hospitals in the course of the PHE.
Since March 2020, with the declaration of the PHE, CMS has waived numerous Medicare Hospital Situations of Participation (“CoPs”) and adopted extra regulatory flexibilities to permit hospitals to offer companies in non-traditional settings, together with ASCs and the affected person’s residence via the “Hospitals With out Partitions” program. The blanket waivers can be found to all hospitals who meet the necessities. Regardless of the flexibilities out there via the Hospitals With out Partitions program, the nursing companies CoPs remained a cloth operational obstacle. Particularly, the nursing companies CoPs at 42 C.F.R. § 482.23(b) and (b)(1) required rapid availability of a registered nurse, and 24-hour on obligation nursing companies bodily within the residence or ASC setting – simply as within the 4 partitions of the hospital. Clearly, satisfying these CoP necessities was difficult, significantly in areas with nursing shortages. The Acute Hospital Care at Dwelling program alleviates this operational problem by offering a chance for hospitals to use for and acquire a waiver of this explicit requirement.
The Acute Hospital Care at Dwelling program isn’t the identical as residence well being, and is meant for sufferers who require acute inpatient admission to a hospital and who require no less than each day rounding by a doctor and monitoring. Beneath the Acute Hospital Care at Dwelling program, hospitals that apply for and are granted a waiver will institute screening protocols to establish inpatient or emergency division sufferers with a qualifying situation, akin to bronchial asthma, congestive coronary heart failure, pneumonia, or COPD, who want to take part in this system. These sufferers will likely be evaluated in-person after which admitted to their properties, the place they’ll obtain no less than two in-person visits per day from a RN or paramedic and a once-daily analysis by a RN, both remotely or in-person. The hospital should submit monitoring information on a month-to-month foundation. This new program is much like the prevailing Medicare Well being Care Innovation Program for Acute Hospital Care at Dwelling that was initially awarded to 6 hospitals, exterior the PHE. Hospitals wishing to take part within the Acute Hospital Care at Dwelling initiative can overview FAQs right here and apply right here.
Candidates ought to fastidiously contemplate how they’ll implement the brand new program, together with how they’ll guarantee continued compliance with the opposite Hospital CoPs that haven’t been waived.
CMS concurrently introduced flexibility for ASCs enrolled as hospitals in the course of the PHE in order that these services are solely required to offer 24-hour on-site nursing companies when there’s a affected person within the facility.
ASCs which can be enrolled as hospitals can view extra data on the ASC flexibilities right here.
© Polsinelli PC, Polsinelli LLP in CaliforniaNationwide Legislation Overview, Quantity X, Quantity 336