Trump Administration
Acts to Ensure U.S. Healthcare Facilities Can Maximize Frontline Workforces
to Confront COVID-19 Crisis
Yesterday, at President Trump’s direction, the Centers for
Medicare & Medicaid Services (CMS) temporarily suspended a number of
rules so that hospitals, clinics, and other healthcare facilities can boost
their frontline medical staffs as they fight to save lives during the 2019
Novel Coronavirus (COVID-19) pandemic.
These changes affect doctors, nurses, and other clinicians
nationwide, and focus on reducing supervision and certification
requirements so that practitioners can be hired quickly and perform work to
the fullest extent of their licenses. The new waivers sharply expand the
workforce flexibilities CMS announced on March 30.
CMS sets and enforces essential quality and safety standards
for the nation’s healthcare system that supplement State scope-of-practice
and licensure laws for healthcare workers. CMS has continuously examined
its regulations to identify areas where Federal requirements may be more
stringent than State laws and requirements. The changes CMS is announcing
today will ensure that healthcare facilities across the nation can expand
their staffs and organize them in the most efficient way possible to handle
the incoming surge of COVID-19 patients.
Hospitals and health systems throughout the U.S. are seeing
increases in patient volumes, leading to significant challenges in
delivering vital services. Allowing clinicians to practice to the full
scope of their licenses is critical to address staffing needs during the
public health emergency.
As a result of CMS’s action:
- Doctors can now directly care for patients at rural
hospitals, across state lines if necessary, via phone, radio, or
online communication, without having to be physically present.
Remotely located physicians, coordinating with nurse practitioners at
rural facilities, will provide staffs at such facilities additional
flexibility to meet the needs of their patients.
- Nurse practitioners, in addition to physicians, may
now perform some medical exams on Medicare patients at skilled nursing
facilities so that patient needs, whether COVID-19 related or not,
continue to be met in the face of increased care demands.
- Occupational therapists from home health agencies
can now perform initial assessments on certain homebound patients,
allowing home health services to start sooner and freeing home-health
nurses to do more direct patient care.
- Hospice nurses will be relieved of hospice aide
in-service training tasks so they can spend more time with patients.
“It’s all hands on deck during this crisis,” said CMS
Administrator Seema Verma. “All frontline medical professionals need to be
able to work at the highest level they were trained for. CMS is making sure
there are no regulatory obstacles to increasing the medical workforce to
handle the patient surge during the COVID pandemic.”
CMS’s workforce changes apply immediately and address
supervision, licensure and certification, and other limitations in
healthcare settings including Critical Access Hospitals (CAHs), Rural
Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Skilled
Nursing Facilities (SNFs), Home Health Agencies (HHAs), and Hospice. These
actions are part of the unprecedented array of temporary regulatory waivers
and new rules issued recently by CMS and intended to help the American
healthcare system respond to COVID-19.
CMS is the nation’s largest health insurer, serving more than
140 million Americans through Medicare, Medicaid, the Children’s Health
Insurance Program, and Federal Exchanges.
On March 30, CMS issued an unprecedented array of temporary
regulatory waivers and new rules to allows hospitals and healthcare systems
to deliver services at other community-based locations to make room for
COVID-19 patients needing acute care in their main facilities. The changes
complement and augment the work of FEMA and state and local public health
authorities by empowering hospitals and healthcare systems to rapidly
expand treatment capacity and separate infected from uninfected patients.
CMS’s waivers and flexibilities will permit patients to be triaged to a
variety of community-based locales, including ambulatory surgery centers,
inpatient rehabilitation hospitals, hotels, and dormitories. Transferring
uninfected patients will help hospital staffs to focus on the most critical
COVID-19 patients, maintain infection control protocols, and conserve
personal protective equipment (PPE).
In recent weeks, CMS also has temporarily:
- Permitted physicians whose privileges will expire
to continue practicing at a hospital, and allowed new physicians to
begin working prior to full hospital medical staff/governing body
review and approval.
- Lifted regulatory requirements regarding hospital
personnel qualified to perform specific respiratory care procedures,
allowing these professionals to operate to the fullest extent of their
licensure.
- Waived federal minimum personnel qualifications for
clinical nurse specialists, nurse practitioners, and physician
assistants so they can work at rural hospitals as long as they meet
state licensure requirements, allowing for maximum staffing
flexibility at such facilities.
- Allowed physicians and non-physician practitioners
to use telehealth technology to care for patients at long-term care
facilities, rather than having to treat patients there in person.
- Waived certain training and certification
requirements for nurse’s aides at long term care facilities, to help
address potential staffing shortages during the pandemic.
- Waived paperwork requirements so that hospital
doctors can use more verbal, rather than written medical orders.
These actions, and earlier CMS actions in response to
COVID-19, are part of the ongoing White House Coronavirus Task Force
efforts. To keep up with the important work the Task Force is doing in
response to COVID19, visit www.coronavirus.gov.
For a complete and updated list of CMS actions, and other information
specific to CMS, please visit the Current
Emergencies Website.
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