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The Centers for Medicare and Medicaid Services has eased a number of service restrictions on physicians who provide care for residents in skilled nursing and long-term care facilities.

The changes join a growing list of so-called “blanket waivers” temporarily granted to healthcare providers and institutions during the COVID-19 crisis. The physician waivers specifically address staff shortages in facilities caring for patients with the coronavirus.

Among the measures:

  • Physicians are not required to perform in-person visits for nursing facility residents and may instead conduct visits via telehealth options as appropriate.
  • Physicians may now delegate tasks to a physician assistant or nurse practitioner who meets requirements 42 C.F.R. 491.2, or to a state-licensed clinical nurse specialist. However, physicians must supervise the tasks.
  • Physicians may delegate required visits to a physician assistant, nurse practitioner or clinical nurse specialist who is not a facility employee, who works in collaboration with a physician, and is state licensed.

The changes do not waive requirements for frequency of physician visits or the requirement that the facility provide or arrange for physician services 24 hours a day in case of an emergency. “It is important that a physician be available for consultation regarding a resident’s care,” the agency states.

“The actions will assist in potential staffing shortages, maximize the use of medical personnel and protect the health and safety of residents during the public health emergency,” it concluded.

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