Change ahead as COVID emergency ends
The Biden administration’s decision to end the COVID-19 public health emergency in May will institute sweeping changes across the health care system that go far beyond many people having to pay more for COVID tests.
In response to the pandemic, the federal government in 2020 suspended many of its rules on how care is delivered. That transformed essentially every corner of U.S. health care — from hospitals and nursing homes to public health and treatment for people recovering from addiction.
Now, as the government prepares to reverse some of those steps, here’s a glimpse at ways patients will be affected:
The end of the emergency means nursing homes will have to meet higher standards for training workers.
Advocates for nursing home residents are eager to see the old, tougher training requirements reinstated, but the industry says that move could worsen staffing shortages plaguing facilities nationwide.
In the early days of the pandemic, to help nursing homes function under the virus’ onslaught,
the federal government relaxed training requirements. The Centers for Medicare & Medicaid Services instituted a national policy saying nursing homes needn’t follow regulations requiring nurse aides to undergo at least 75 hours of stateapproved training. Normally, a nursing home couldn’t employ aides for more than four months unless they met those requirements.
Last year, CMS decided the relaxed training rules would no longer apply nationwide, but states and facilities could ask for permission to be held to the lower
standards. As of this month, 17 states had such exemptions, according to CMS — Texas, Georgia, Indiana, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, New Jersey, New York, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont and Washington — as did 356 individual nursing homes in Arizona, California, Delaware, Florida, Illinois, Iowa, Kansas, Kentucky, Michigan, Nebraska, New Hampshire, North Carolina, Ohio, Oregon, Virginia, Wisconsin and Washington, D.C.
Adequate training of aides is crucial so “they know what they’re doing before they provide care, for their own good as well as for the residents,” said Toby Edelman, a senior policy attorney for the Center for Medicare Advocacy.
The American Health Care Association, the largest nursing home lobbying group, released a December survey finding that roughly 4 in 5 facilities were dealing with moderate to high levels of staff shortages.
During the pandemic, CMS has tried to limit problems that could arise if there weren’t enough health care workers to treat patients — especially before there were COVID vaccines, when workers were at greater risk of getting sick.
For example, CMS allowed hospitals to make broader use of nurse practitioners and physician assistants when caring for Medicare patients. And new physicians not yet credentialed to work at a particular hospital — for example, because governing bodies lacked time to conduct their reviews — could nonetheless practice there.
Other changes during the public health emergency were meant to shore up hospital capacity. Critical access hospitals, small hospitals in rural areas, didn’t have to comply with federal rules for Medicare stating they were limited to 25 inpatient beds and patients’ stays could not exceed 96 hours, on average.
Once the emergency ends, those exceptions will disappear.
Hospitals are trying to persuade federal officials to maintain multiple COVID-era policies beyond the emergency or work with Congress to change the law.
The way state and local public health departments monitor the spread of disease will change after the emergency ends because the Health and Human Services Department won’t be able to require labs to report COVID testing data.
Without a uniform, federal requirement, how states and counties track the spread of the coronavirus will vary. In addition, though hospitals will still provide COVID data to the federal government, they may do so less frequently. Kaiser Health News is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at Kaiser Family Foundation. KFF is an endowed nonprofit providing information on health issues to the nation.