Covid-19

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,

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.