CMS Eases Assessment Rules for HHAs, Therapists After Helene

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) issued a blanket waiver that allows physical therapists and speech language pathologists to perform initial and comprehensive assessments in instances where therapy is ordered for home health agencies (HHAs) impacted by Hurricane Helene. 

Additionally, CMS modified some hospice requirements that involve updating comprehensive assessments of patients. 

Below are the modifications:

HHAs

• Reporting: CMS is providing relief to HHAs on the timeframes related to OASIS Transmission through the following actions below:
  • Extending the 5-day completion requirement for the comprehensive assessment to 30 days.
  • Modifying the 30-day OASIS submission requirement. Delayed submission is permitted during the PHE.
• Initial Assessments: CMS is waiving the requirements at 42 CFR §484.55(a) to allow HHAs to perform Medicare-covered initial assessments and determine patients’ homebound status remotely or by record review. This will allow patients to be cared for in the best environment for them while reducing the impact on acute care and long- term care facilities. This will allow for maximizing coverage by already scarce physician, and advanced practice clinicians, and allow those clinicians to focus on caring for patients with the greatest acuity.
• Allow Physical Therapists (PTs), and Speech Language Pathologists (SLPs) to perform Initial and Comprehensive Assessment for all Patients: CMS is waiving the requirements in 42 CFR § 484.55(a)(2) and § 484.55(b)(3) that rehabilitation skilled professionals may only perform the initial and comprehensive assessment when only therapy services are ordered. This temporary waiver will allow any rehabilitation professional (PT, or SLP) to perform the initial and comprehensive assessment for all patients receiving therapy services as part of the plan of care, to the extent permitted under state law, regardless of whether or not the service establishes eligibility for the patient to be receiving home care.
• Of note, as a part of the CY 2022 Home Health Prospective Payment System Final Rule (CMS 1747-F), CMS finalized changes to § 484.55(a) and (b)(2) to permanently allow Occupational Therapists (OT) to complete the initial and comprehensive assessments for patients, in accordance with Division CC, section 115 of CAA 2021. 

Hospice

• Comprehensive Assessments: CMS is modifying certain requirements at 42 CFR §418.54 related to updating comprehensive assessments of patients. This modifies the timeframes for updates to the comprehensive assessment found at §418.54(d). Hospices must continue to complete other required assessments (i.e., initial and ad-hoc assessments based on a change in the patient's condition); however, the timeframes for updating the comprehensive assessment may be extended from 15 to 21 days. 

For a full list of available waivers for counties impacted by Hurricane Helene, visit here.