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CMS Guidance for Home Health Agencies to Minimize Spread of COVID-19

Coronavirus Health CareOn April 23, 2020, the Centers for Medicare and Medicaid Services (CMS) updated its guidance on infection control and prevention of COVID-19 for Home Health Agencies (HHAs). CMS provided initial guidance on March 10, 2020, which addressed the concerns of COVID-19 and provided answers to practical questions impacting HHAs. In this update, CMS has expanded the COVID-19 guidance and regulations to apply to Religious Nonmedical Healthcare Institutions (RNHCIs).

A RNHCI is a facility that provides nonmedical nursing items and services to beneficiaries who rely solely on a religious method of healing, as medical services are inconsistent with their religious beliefs. These settings are unique in that they generally do not perform screenings and examinations to determine the diagnosis of the patient. In light of the current circumstances, CMS is encouraging the medical professionals at these facilities to closely monitor patients for potential symptoms or exposure to COVID-19 to prevent the spread of COVID-19 within the facility. A RNCHI must provide basic screening and report potential infected patients to their local health department.

HHAs and RNCHIs are advised to comply with the Centers for Disease Control (CDC) guidance on mitigating transmission of the virus through isolation, restriction of activities, and restriction of visitors. These entities are expected to provide CDC guidance to patients who are infected with COVID-19. HHA staff is permitted to access patients in assisted and independent living facilities, as long as they have appropriate personal protective equipment, do not have symptoms of COVID-19, and are providing direct care. If a COVID-19 infected patient is discharged from an HHA, the receiving service provider and the healthcare transport personnel must be notified of their medical status.

CMS has issued a variety of waivers of requirements and regulations for health care providers during the COVID-19 Public Health Emergency. This guidance reiterates the availability of these waivers. For example, HHAs are encouraged and permitted to bill for telehealth services during the Public Health Emergency for an expanded number of services during the Public Health Emergency. CMS is also temporarily waiving onsite visits for supervision and extending the time for OASIS data to be submitted.  Foster Swift analysis and more information on CMS waivers are available here.

When an HHA or RNCHI is providing care in a patient’s home, they should identify patients at risk for COVID-19 and screen the patients by asking about recent international travel, signs or symptoms of COVID-19, recent contact with someone infected with COVID-19 and whether they reside in a community dealing with a widespread community-based transmission of COVID-19. Since not all patients known or suspected to have COVID-19 require hospitalization, many may remain in their home and receive care through an HHA. Therefore, it is critical for health care personnel to screen patients before or immediately upon entering the home as recommended by CMS.

The CMS guidance for HHAs and RNCHIs is available here. Contact a member of Foster Swift’s health care group with any questions on complying with the rapidly changing provider requirements.

Jennifer Van Regenmorter; jvanregenmorter@fosterswift.com

Caroline Renner; crenner@fosterswift.com

While the information in this article is accurate at time of publication, the laws and regulations surrounding COVID-19 are constantly evolving. Please consult your attorney or advisor to make sure you have the most up to date information before taking action.

Categories: Health Care Reform, Medicare/Medicaid

 has particular expertise in health law and she represents providers with emphasis in the areas of physicians, hospice, home care and long term care, including one of the country’s largest long-term care organizations. She has a vast array of experience in teaming with providers in the areas of regulatory compliance and contracts. 

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