Patients must continue to be discharged to an appropriate setting, per CMS.

As hospitals continue in their struggle to treat patients for COVID-19, the illness caused by the novel coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has modified its requirements for discharge planning.

According to Ronald Hirsch, MD, CMS is waiving certain requirements related to hospital discharge planning for post-acute care services at 42 CFR §482.43(c), so as to expedite the safe discharge and movement of patients among care settings, and to be responsive to fluid situations in various areas of the country.

Hirsch said CMS is waiving certain requirements for those patients discharged home and referred for home health aide (HHA) services, for patients transferred to a skilled nursing facility (SNF) for post-hospital extended care services, or patients transferred to an inpatient rehabilitation facility (IRF) or long-term care hospital (LTCH) for specialized hospital services.

“For example,” said Hirsch, “a patient may not be able to receive a
comprehensive list of nursing homes in their geographic area, but must still be discharged to a nursing home that is available to provide the care that is needed by the patient.”

In other news, CMS announced that it will also now temporarily permit non-hospital buildings and spaces to be used for patient care and quarantine sites, provided that the location is approved by the state and ensures the safety and comfort of patients and staff. This will expand the capacity of communities to develop a system of care that safely treats patients without COVID-19, and to isolate and treat patients with COVID-19.

CMS said it will also allow hospitals, laboratories, and other entities to perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital, a measure intended to increase access to testing and reduce risks of exposure.

“The new guidance allows healthcare systems, hospitals, and communities to set up testing sites exclusively for the purpose of identifying COVID-19-positive patients in a safe environment,” the agency said in an announcement.

In addition, CMS will allow hospital emergency departments to test and screen patients for COVID-19 at drive-through and off-campus test sites.

“During the public health emergency, ambulances can transport patients to a wider range of locations when other transportation is not medically appropriate,” CMS said. “These destinations include community mental health centers, federally qualified health centers (FQHCs), physician’s offices, urgent care facilities, ambulatory surgery centers, and any locations furnishing dialysis services when an ESRD facility is not available.”

Physician-owned hospitals also have been permitted to temporarily increase the number of their licensed beds, operating rooms, and procedure rooms. For example, a physician-owned hospital may temporarily convert observation beds to inpatient beds to accommodate patient surges.

Programming Note: Listen to Dr. Ronald Hirsch every Monday on Monitor Mondays, 10-10:30 a.m. EST.

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