Posted by:  Gina Salamone

CMS (Centers for Medicare & Medicaid Services) has issued temporary guidance and changes in order to combat the spread of COVID-19 among elderly Americans.

Waiver of the 3-Day Rule
After a hospital stay, many seniors transition to a skilled nursing facility where they can receive rehab services before returning home.  CMS rules state that that a patient is eligible for inpatient rehab at a skilled nursing facility for up to 100 days only after a 3 day stay at a hospital.  For those days to be covered under Medicare, the patient must have been an inpatient at the hospital for consecutive 3 days and cannot have been there for observation or in the emergency department.

Medicare is temporarily waiving this requirement so that elderly patients can be transferred to skilled nursing quickly, reserving hospital beds for more severely ill patients.  CMS is also expanding the ability of patients to reenter skilled nursing rehab on Medicare even if their 100 days have been exhausted.

Restriction on Visitation
CMS has also instructed nursing homes to restrict all visitation within nursing homes as well as all group activities.  This, unfortunately, means that families can no longer visit loved ones including those who may have dementia or mental health issues.  CMS allows for exceptions for end-of-life situations as long as the visiting relatives wear protective gear, are restricted to one room and limit the length of their visit.  CMS also allows that States may issue even more restrictive guidelines.

This new directive is designed limit the spread of COVID-19 but also greatly effects the emotional well-being of nursing home residents.  Families are encouraged to work with nursing home staff to set up calls and Facetime with their loved ones.  This restriction is to be lifted as soon as reasonably possible, but will likely remain in effect for some time.