The COVID-19 public health emergency is winding down — are you ready?

January 11, 2023
Categories: Corporate, Diversified care network, Home health, Hospitals & health systems, Hospice, Life plan community, Private duty, Senior living, Skilled nursing, Palliative care
Reading Time: 4 minutes

By: Brandy Shifteh, RN, BHSA, MBA, Regulations Compliance Manager, MatrixCare and Carolyn Dean, Regulations Compliance Manager, MatrixCare

Throughout the COVID-19 public health emergency (PHE), the Centers for Medicare and Medicaid Services (CMS) has used a combination of waivers and broad flexibilities to ensure access to care and to give healthcare providers what they need to respond to the pandemic. The emergency authority waivers and flexibilities also promote effective infection prevention and safety measures for staff and patients. Since these were intended to address the acute circumstances of a rapidly evolving pandemic and not replace existing requirements, many will terminate at either the end of the PHE or within a specific timeframe after the PHE terminates. It should also be noted that some waivers were already terminated during the PHE.

To help providers prepare for future events, CMS has developed a roadmap for the eventual end of the Medicare PHE waivers and flexibilities. Similar to the guidance CMS has made available to states, they’ve also released fact sheets in an effort to help the health care sector transition their operations once the PHE ends.

Also, to minimize any disruptions like potential coverage losses, the Department of Health and Human Services (HHS) has committed to giving the states and the healthcare community a 60-day notice before ending the PHE. In the meantime, CMS continues to encourage all providers to prepare for the end of these flexibilities now, and to begin moving forward to re-establishing compliance with previous health and safety standards and billing practices.

Is your agency ready for the PHE to end? In this blog, we review four key areas to help support your organization’s success with returning to a pre-pandemic state of compliance.

Assess your agency’s current use and need of CMS waivers/flexibilities. With the COVID-19 PHE winding down, assess whether the existing active waivers and/or flexibilities are in use and whether they are still needed by your organization. Will they end before the PHE is terminated or at the same time of the PHE? Are they to be extended beyond the PHE on a temporary basis? Have they or are they to be made permanent? These are just a sample of the questions providers should ask to thoroughly prepare for the end of PHE.

Identify existing federal, state and/or local COVID-19 PHE waivers, then identify which have terminated, which are permanent, and which remain active. CMS reminds providers that these waivers and flexibilities were intended to assist organizations with the challenges or barriers directly impacting those that serve patients through the COVID-19 PHE and not a blanket waiver to allow non-compliance to a condition of participation or other regulation should there not be a need. Also, keep abreast of pending legislation that might extend certain waivers and/or provisions. For example, there is draft legislation that if signed into law would extend certain telehealth services beyond the PHE.

Develop and implement a plan to return to a pre-pandemic state of compliance. Based on the results of your organizational assessment, plan enough time to prepare your organization for the end of the PHE and return to normal operations. The plan should address ending reliance on PHE waivers and flexibilities as needed. Be sure to identify what “normal operations” looks like, set timebound goals and assign owners, and educate staff on all levels. Also, continue to monitor for waiver and other legislative updates at the federal, state and local levels through to the end and after the PHE.

Be survey ready. Being prepared for surveys means being prepared for the end of the PHE. As providers monitor for information from federal, state and local entities, they must remember that most stringent regulation must be followed when different at these levels. Failure to understand this can lead to poor survey results — here are a few ways to be survey (and post-PHE) ready:

  • Understand that CMS medical review focus, audits and procedures will be performed through to the end of the PHE and after the PHE.
  • Assess your current quality review systems, and initiate focused medical record compliance audits.
  • Review and test your emergency preparedness and infection control plans.
  • Re-establish staff evaluation, supervision and competencies as applicable; audit personnel records.
  • Update policies and procedures as needed.
  • Educate/train staff on all levels.

The time to prepare for the end of the PHE is now — are you ready? Schedule a demo with MatrixCare to learn how your organization can experience this transition with ease.

UPDATE: The Secretary of Health and Human Services (HHS) announces extension of the COVID-19 public health emergency (PHE)

On January 11, 2023, the Secretary of Health and Human Services (HHS), Xavier Becerra, announced the extension of the COVID-19 public health emergency (PHE) for another 90 days. As a reminder, the HHS Secretary has committed to provide states and healthcare stakeholders 60 days advanced notice prior to terminating the COVID-19 PHE.

Industry considerations/actions to take: Providers should share this announcement with appropriate staff members. The extension of the COVID-19 PHE means that any COVID-19 waivers that have not yet been terminated or set to expire on a specific date will continue to be in effect. A list of the federal blanket waivers and their statuses for home health and hospice can be accessed on the CMS Current Emergencies website.

Although the COVID-19 PHE has been extended, allowing for the extension of certain PHE waivers, providers should be taking the appropriate steps to prepare for the end of the PHE. This includes identifying and monitoring the status of federal, state and local waivers that are still in use by your agency and making appropriate plans to re-establish compliance with previous health and safety standards and billing practices.

DISCLAIMER: This information is provided for informational purposes only and is not intended to be, and should not be construed as, legal advice.


Regulatory Compliance
Regulatory Compliance

Brandy Shifteh, RN, BHSA, MBA and Carolyn Dean are Regulatory Compliance Managers for MatrixCare Home Health and Hospice. They are responsible for monitoring and analyzing CMS regulations that impact home health, hospice, and private duty home care. They work diligently to ensure the product and service solutions at MatrixCare support compliance for all existing and new regulations. With over 60 years of combined experience, both Brandy and Carolyn have extensive connections in the regulatory community with relationships at both the state and federal levels.


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