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Skilled nursing facilities brace for impact as Medicare coverage shifts

As the COVID-19 public health emergency ends, elderly people who need post-hospital care in a skilled nursing facility (SNF) may find that conventional Medicare does not cover their expenses.

The modification, one of many that affect older persons, reinstates the laws that were in place before the outbreak. 

Medicare Reinstates Pre-Covid Rule

Yet because they are so intricate and shocking to so many patients and their families, some may go without care, while others will be compelled to seek out home health care, which Medicare does cover.

The fundamental pre-Covid regulation stated that a patient could only get regular Medicare benefits for a stay in an SNF after being admitted to the hospital for a minimum of three consecutive days. 

The cost would be borne by others out of their own pockets. During the pandemic, Medicare waived the provision, but it has since been reinstated.

Less than 10,000 employees return each month to nursing homes, which has resulted in a loss of about 210,000 workers since February 2020.

 Some healthcare facilities, such as assisted living, have increased their personnel levels above those prior to the pandemic.

Prior to working directly with patients, all nurse assistants were required to complete at least 75 hours of mandatory training and pass a state-level competency test under long-standing federal regulations. 

However, under the PHE, federal regulators initially offered a broad waiver of these requirements.

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Nursing Homes Face Staffing Crisis

skilled-nursing-facilities-brace-for-impact-as-medicare-coverage-shifts
As the COVID-19 public health emergency ends, elderly people who need post-hospital care in a skilled nursing facility (SNF) may find that conventional Medicare does not cover their expenses.

Although throwing the industry a lifeline by giving new temporary nurse aide waivers on a state, county, or facility basis, CMS this year repealed some COVID-era regulations. With the lifting of the Restriction, surviving temporary aids in any of the 20 states that had granted such waivers—many of which cited testing backlogs—now have four months to become certified.

By providing new temporary nurse aide waivers on a state, county, or facility basis and giving the business a lifeline, CMS this year abolished some COVID-era requirements. 

In any of the 20 states that had given such waivers—many of which cited testing backlogs—surviving temporary aids now had four months to become certified.

Over the duration of the pandemic, the waiver, according to PHCA, gave 4,500 new certified nurse aides a different, paid on-the-job training option. Based on the assumption that each skilled facility would turn eight temporary assistants (TNAs) on average into full-time employees, 17% of facilities would not need any TNAs at all.

Currently, many providers are facing the same challenges they did before the pandemic: how to find prospective CNAs, enroll them in training programs that have been recognized by the state, and have them tested swiftly.

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