The Husch Blackwell Hospice Team has been receiving reports from hospices throughout the country that nursing facilities are prohibiting hospice workers from entering the facility to provide essential end-of-life care to hospice patients. Such access is being denied pursuant to visitor restrictions. However, hospice personnel are not visitors but are recognized by the Centers for Medicare and Medicaid Services (“CMS”) as essential health care personnel who must be given access.
On March 20, 2020, the Texas Health and Human Services Commission issued Provider Letter 20-23, providing clear guidance to Texas’ assisted living communities on how to reduce the risk of the spread of COVID-19. Finding that; “…COVID-19 presents a significant health and safety risk to ALF residents” and that “the best method of protecting [residents] from infection is to keep the infection out of the facility”, the provider letter adopts guidelines that are similar to those put in place several days ago for nursing facilities. Significantly, the letter determines that; “[a] resident’s right to visitation can be restricted in order to protect the health and safety of residents”.
The Families First Coronavirus Response Act (the Act) was passed and signed into law on March 18 and will go into effect on April 2, 2020 and continue until December 31, 2020. As our colleagues Josef Glynias and Paul Pautler noted in their excellent summary, this Act has two provisions which speak to employee leave and may have significant implications for employers, including healthcare providers. The Department of Labor has not yet issued guidance on this Act, and we will update this blog as guidance is issued.
These are extraordinary times. COVID-19, or the novel coronavirus, has disrupted the life of every American and every business. Hospices are no exception. In fact, they are on the frontlines, responsible for providing care to the elderly, a population extremely susceptible to COVID-19. The Husch Blackwell Hospice Team is fundamentally a group of problem solvers,
The CDC’s latest Morbidity and Mortality Weekly Report released Wednesday, March 18, 2020, reiterated that both residents and the workforce of long term care facilities remain most vulnerable to the exposure and spread of COVID-19. According to the Report, “[s]ubstantial morbidity and mortality might be averted if all long-term care facilities take steps now to prevent exposure of their residents to COVID-19. The underlying health conditions and advanced age of many long-term care facility residents and the shared location of patients in one facility places these persons at risk for severe morbidity and death.”
Husch Blackwell’s Wakaba Tessier and Erica Ash have published a post on Husch Blackwell’s Byte Back privacy blog detailing a new announcement from the Office of Civil Rights of the U.S. Department of Health and Human Services that relaxes the HIPAA Security Rule in response to the COVID-19 crisis, expanding on our previous discussion on
On March 17, 2020, President Trump announced the expansion of Medicare telehealth coverage to allow providers to virtually visit with Medicare beneficiaries amid the COVID-19 pandemic. The telehealth benefits expansion is in accordance with the President’s emergency declaration under the Stafford Act and the recently passed Coronavirus Preparedness and Response Supplemental Appropriations Act. By expanding telehealth benefits for Medicare beneficiaries, the Trump administration hopes to alleviate pressure on healthcare facilities that deal with urgent cases and ensure that elderly beneficiaries may seek care while minimizing exposure to the virus.
On Friday, March 13, 2020, CMS issued blanket waivers under 42 U.S.C. 1320b-5 that impact long term acute care hospitals (LTCHs) and inpatient rehabilitation facilities (IRFs) as a result of President Trump declaring a state of an emergency due to COVID-19. The blanket waivers temporarily allow facilities operating inpatient rehabilitation units to exclude patients admitted
Centers for Medicare and Medicaid Services (CMS) has issued broad waivers to assist in the national COVID-19 response. They impact all provider types and generally remove regulatory burdens that could restrict access to care. For example, the waivers remove bed limits on Critical Access Hospitals and will allow Long Term Hospitals to exclude from the 25 ALOS calculation patients who were admitted or discharged to “meet the demands of the emergency.” Restriction on the separation of patients in excluded units in IPPS hospitals are waived. The requirement for three days of hospitalization to receive skilled nursing coverage is also waived. There are a number of other waivers.
In the wake of the COVID-19 global pandemic declaration, hospice providers are faced with the difficult conundrum of ensuring the continuity of care for their vulnerable patients while attempting to comply with the recent CDC and CMS guidelines regarding post-acute care facilities’ lock-down procedures. There is no question the intentions of long-term care facilities are well-meaning in an effort to protect its residents who are most susceptible to COVID-19 complications.[1] However, these precautionary measures put residents receiving hospice services at risk of missing supportive treatment and important care planning. The American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) derived its skilled nursing facility visitor restriction recommendations from the CMS revised guidance issued March 9, 2020, and hospice providers should take note of these recommendations to ensure they are not prohibited from caring for their patients.