Hurricane Isaac: Emergency-Related Policies and Procedures for Skilled Nursing Facilities

Members | August 29, 2011

Information about the MDS 3.0 relating to resident transfers during natural disasters.

As a response to the many questions we received on how the Minimum Data Set 3.0 deals with resident transfers during a natural disaster, please see the bullets below from Chapter 2 in the MDS 3.0 manual. Based on the manual and Centers for Medicare and Medicaid Services (CMS), nursing homes are instructed to contact their CMS regional Offices or Medicare contractors with any questions.

MDS 3.0 Manual, Ch 2: Resident Transfers  

When there has been a transfer of residents as a result of a natural disaster(s) (e.g., flood, earthquake, fire) with an anticipated return to the facility, the evacuating facility should contact their regional office, state agency, and Medicare contractor for guidance.

When there has been a transfer as a result of a natural disaster(s) (e.g., flood, earthquake, fire) and it determined that the resident will not return to the evacuating facility, the evacuating provider will discharge the resident return not anticipated and the receiving facility will admit the resident, with the MDS cycle beginning as of the admission date to the receiving facility. 

For questions related to this type of situation, providers should contact their State agency and their Regional Office, State agency, and Medicare contractor for guidance.”

Providers will need their National Provider Numbers (NPI) when they call.  In the mean time, LeadingAge will continue to be in direct communication with the CMS office for more detailed guidance.

A 1135 Waiver can be granted by CMS to certain states and providers to modify certain requirements for Medicare/Medicaid due to a hurricane. A 1135 Waiver is given in certain events or emergencies that are: 

  1. Declared as an emergency/disaster under the Stafford Act or the National Emergencies Act.
  2. Declared as a Public Health Emergency under Section 319 of the Public Health Service Act by the secretary. 

The decision to grant these waivers is made by CMS and on a case-by-case basis, during or after the emergency and retroactive to the starting date of the emergency.  

It may be helpful for providers to review a CMS document for emergency-related policies and procedures that may be implemented without the 1135 waivers - scroll down to Section T for SNF providers (Q&A T1 and T2 may be of particular importance as it deals with coding and payment).