CMS Issues Home Health COVID-19 Guidance, Eases Supplies Standards

After days of issuing updated guidance for skilled nursing operators and other Medicare providers regarding COVID-19, the U.S. Centers for Medicare & Medicaid Services (CMS) is now turning its attention to home health agencies.

CMS issued home health guidance related to infection control and prevention for COVID-19 — often referred to as the coronavirus — on Tuesday night.

While the guidance is largely nothing home health agencies don’t already know, it stands as a reminder of the severity of the situation, which is worsening by the hour.

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At least 31 people in the United States have died as a result of the coronavirus, with nearly 1,000 more falling ill. Multiple states have declared a state of emergency to round up additional resources aimed at combating the virus.

“We are arming our providers on the front lines with the information they need to remain safe, while giving quality care to their patients,” CMS Administrator Seema Verma said in a statement. “Today’s guidance will help providers identify patients who may have contracted the disease and minimize further transmission. It will also equip them to get these patients the medical care they need in order to recover.”

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CMS guidance to home health agencies is meant to reinforce recommendations set forth by the U.S. Centers for Disease Control and Prevention (CDC), with specific considerations of when it is safe to treat patients at home and when patients should be considered for hospitalization.

CMS’s guidance also suggests home health providers should take a more assertive role in monitoring family-member exposure when caring for patients with known or suspected COVID-19 cases.

“CMS is recommending home health agencies remain vigilant, regularly monitor patients for any symptoms of the virus, and communicate effectively with patients, family members and other caregivers so that the entire care team understands a patient’s individual needs and goals of care,” CMS officials stated.

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CMS said that the new guidance is meant to answer questions that the agency has received from Medicare and Medicaid in-home care providers related to the COVID-19 outbreak.

While there aren’t many reports of home health providers caring for patients with confirmed COVID-19 at the moment, CMS encouraged home health providers to continue treatment at home — as long as patients could continue isolation protocols and infection-prevention practices.

Following a logical timeline, home health provider interaction is likely to increase as COVID-19 patients are discharged from the hospital.

“Initially, symptoms may be mild and not require transfer to a hospital as long as the individual with support of the [home health agency] can follow the infection prevention and control practices recommended by CDC,” CMS noted.

Apart from patient and clinician exposure, some home health providers have begun to worry about supply capacity and maintaining existing Medicare standards.

CMS put some of those concerns to rest.

“State and Federal surveyors should not cite home health agencies for not providing certain supplies … if they are having difficulty obtaining these supplies for reasons outside of their control,” policymakers stated.

Those supplies typically include items such as gowns, respirators, surgical masks and alcohol-based hand rubs.

On Saturday, U.S. Surgeon General Jerome Adams implored Americans to stop buying medical masks, calling attention to ongoing need within the medical community. Throughout the country, masks have widely sold out at stores where available, with price gouging happening online.

National Association for Home Care & Hospice (NAHC) President William A. Dombi discussed coronavirus concerns with Home Health Care News last week.

“This is one of those times when the home health agencies have to figure out where the balance is to be struck between the safety of their staff and caring for the patients that they have,” Dombi said. “When you have patients who are on service already, they are absolutely the priority for care. One of the things we suggest is that agencies take a look at their ability to meet their current patient census.”

Tuesday’s guidance from CMS also included dialysis facilities.

CMS is urging dialysis facilities to identify high-risk individuals prior to appointments or upon arrival and immediately begin screening for fever or symptoms of a respiratory infection. Typically, those symptoms include cough and sore throat.

Generally, CMS urges all Medicare providers to inquire about travel to restricted countries within at least 14 days.

The full guidance is available here.

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