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COVID-19 PHE and the 3-Day Prior Hospitalization Blanket Waiver

Published on 

Wednesday, May 18, 2022

 | COVID-19 


We are having skilled nursing facilities (SNFs) not take patients until they have had a 3 midnight stay. Is the COVID-19 waiver still in effect?


Effective March 1, 2020, CMS implemented 1135 blanket waivers to expand the Administration’s efforts against COVID-19. These waivers are in effect through the end of the emergency declaration or at such time CMS believes it is appropriate to terminate them.

The COVID-19 PHE declaration was last renewed on April 12, 2022 with an effective date of April 16, 2022 (link). When the Secretary of the Department of Health and Human Services (HHS) makes a PHE declaration, it lasts for the duration of the PHE or 90 days but may be extended by the Secretary for as long as the PHE continues to exist.

On April 7, 2022, CMS issued a Memorandum (link) alerting certain providers (i.e., SNFs, NFs, inpatient hospices) of the termination of several COVID-19 blanket waivers. The Memorandum Summary indicates that “applicable waivers will remain in effect for hospitals and critical access hospitals (CAH).”

The 3-Day Prior Hospitalization waiver falls under the Long-Term Care Facilities and Skilled Nursing Facilities (SNFs) and/or Nursing Facilities (NFs) section of the CMS COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers document (link). That said, it is not one of the waivers that is being terminated at this time. You will find the full description of this waiver on page sixteen of the April 7, 2022, iteration of the document.

In January 2021, acting HHS Secretary Norris Cochran sent a letter to governors across the country to share details about the COVID-19 PHE indicating that “when a decision is made to terminate the declaration or let it expire, HHS will provide states with 60 days’ notice prior to termination.”

In a May 10, 2022 letter to HHS Secretary Becerra (link), the American Hospital Association along with several other organizations (i.e., AARP, American Diabetes Association, American Medical and Nurses Associations) urged the PHE be maintained “until we experience an extended period of greater stability and, guided by science and data, can safely unwind the resulting flexibilities.”

As we are now less than 60 days out to the end of the current COVID-19 PHE declaration, it is likely that it will be extended at least through October 2022.

Article Author: Beth Cobb, RN, BSN, ACM, CCDS
Beth Cobb, RN, BSN, ACM, CCDS, is the Manager of Clinical Analytics at Medical Management Plus, Inc. Beth has over twenty-five years of experience in healthcare including eleven years in Case Management at a large multi-facility health system. In her current position, Beth is a principle writer for MMP’s Wednesday@One weekly e-newsletter, an active member of our HIPAA Compliance Committee, MMP’s Education Department Program Director and co-developer of MMP’s proprietary Compliance Protection Assessment Tool.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.