The Centers for Medicare & Medicaid Services has confirmed that the waivers initiated during the public health emergency related to the COVID-19 pandemic will be ending on May 11, 2023.  Most prominently, this includes the TNA waiver and the three-day inpatient stay requirement.

As a part of the Public Health Emergency for COVID-19, the Public Health Service Act allowed various aspects of healthcare delivery to function in a more flexible way to streamline care during the crisis. Two of the most prominent changes within the long-term care setting were the TNA waiver and the three-day inpatient stay requirements. 

The TNA waiver aimed to address staffing shortages during the pandemic, with CMS providing a blanket waiver for nurse aide training and certification requirements that permitted nurse aides to work longer than four months without completing their training. However, CMS has confirmed that this waiver will end on May 11, 2023.

According to CMS, at that time, facilities will have until Sept. 10, 2023, to have all nurse aides who were hired before the end of the public health emergency complete state-approved NATCEP/CEP. Similarly, aides hired after the end of the PHE have up to four months from their date of hire to complete that certification.

The three-day inpatient stay requirement waiver will also be ending at the same time. As part of this waiver, the three-day prior inpatient hospitalization requirement for Medicare coverage of a skilled nursing facility stay was waived during the public health emergency. A release by CMS indicated that this waiver was intended to temporarily expand healthcare capacity during the pandemic and came as part of a group of “blanket waivers” CMS typically issues in response to emergencies. 

However, this waiver “cannot be made permanent without a legislative change,” according to a CMS release. This waiver will end on May 11, 2023, pursuant to President Biden’s announcement to end the national emergency and public health emergency declarations on that date.

CMS did note that the administration, states and private insurance plans will continue to provide guidance in the coming months. Please continue to monitor for further updates. Long-term care providers should be prepared for the expiration of the public health emergency. 

It is strongly suggested that ahead of May 11, 2023, providers contact their legal counsel to make the proper preparations to ensure they continue to operate within full compliance of all the applicable regulations. 

Angela Rinehart is an associate attorney in Stoll, Keenon, Ogden’s (SKO) Health Care and Litigation groups. She joined the firm in 2022 following its merger with Katz Korin Cunningham PC. Contact her at [email protected].

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.