What Expiring COVID PHE Means for Hospice and Palliative Medicine

June 13, 2023

The COVID-19 pandemic has had a profound impact on the healthcare industry, including hospice and palliative medicine. With the aim of returning to pre-pandemic operational norms, significant changes have been implemented in the hospice and palliative medicine landscape as of May 11th, 2023. These changes required hospice providers and patients to navigate a shifting landscape and ensure continuity of care. This means that understanding the expiring Public Health Emergency (PHE) system and effectively adapting to the new post-COVID world, particularly through the changing utilization of telehealth, has become crucial for hospice providers and patients. The role of telehealth will be important in hospice and palliative medicine as we move into the future, though that future remains fluid. In this article, we’ll dive deeper into the impacts these post-pandemic regulatory updates will have on hospice and palliative care and what will return of the pre-pandemic hospice landscape.

What You Need to Know

The medical industry has now entered a transitional period as it rebuilds itself from the setbacks caused by the pandemic and reassesses specific PHE mandates. One of the most significant changes during the PHE was the expansion of telehealth services, enabling providers to deliver remote care to patients. This expansion played a vital role in reducing exposure to COVID, particularly for vulnerable populations in hospice and palliative care.

Going forward, providers will need to prepare for the full return of pre-COVID regulations for staffing, workforce, and training, along with potential payment changes. Most of the pandemic-era flexibilities and waivers, while helpful during a crisis, will be retired as they can be counterproductive during a time of normalcy. While the expansion of telehealth services in some healthcare  settings have been made permanent, other PHE services, such as the hospice face to face, will be extended until 2024.

As for the steps that hospice and palliative agencies can take to align with these post-COVID standards, there are a few key strategies to consider. First, providers must review their current policies and procedures and identify areas that are now non-essential with the end of the Public Health Emergency. This may involve re-evaluating staffing levels, training programs, and equipment needs, among other factors. Second, providers should stay up to date on new regulatory developments and adjust their practices accordingly. Finally, providers should continue to prioritize patient-centered care, using all available resources to ensure that their patients receive the highest quality care possible, even as regulations change.

Regulatory Compliance and Survey Activities

Much like the temporary flexibilities extended to telehealth services during the PHE, CMS waived specific staffing and employee policies that hospice and palliative medicine needed to obey before COVID-19. At the time, these were necessary stop-gap measures intended to offset the burden imposed by the pandemic, including staff shortages and workforce burnout. As the PHE concludes, providers can expect resurgence of regular survey activities and a full review of their hiring, staffing, and training policies to ensure compliance with pre-pandemic operations.

A notable change lies in the intensified emphasis on quality control within patient care. Skilled professionals must conduct annual competency assessments and skills evaluations. In cases of any identified shortcomings, agencies must deliver in-service training programs to address the gaps. Annual training and mandatory education activities for Home Hospice Aides have also resumed effective as of May 11th, 2023.

By embracing these measures, hospice and palliative care providers can confidently provide essential care to their patients while meeting regulatory requirements imposed through surveys.

Workforce Challenges

As the PHE ends, staffing challenges may persist or worsen due to factors like burnout, turnover, and workforce shortages. Providers must implement strategies to retain and recruit qualified staff, address burnout, and prioritize employee well-being. This involves creating supportive work environments, offering competitive compensation and career growth opportunities, and investing in programs geared towards supporting the physical and mental health of healthcare professionals. By prioritizing their workforce’s needs, providers can ensure the continued delivery of high-quality care to patients.

Waivers imposed to reduce administrative stress are also to be lifted immediately following the expiration of PHE. Hospices must employ a volunteer staff capable of fulfilling at least 5% of all patient care hours as they did during pre-PHE times. Additionally, hospice and palliative care units will be required to offer non-core services such as physical therapy, occupational therapy, or speech specialists when required by a patient.

Adjustments Coming to Telehealth

The end of the PHE presents an opportunity for the hospice and palliative care industry to reflect on the lessons learned during the pandemic and to consider the future of the industry. Telehealth demonstrated numerous benefits during the pandemic, such as increased access to care, reduced travel times, and optimized patient outcomes. It is critical to make the case for the ongoing value of telehealth in hospice and palliative care settings, particularly because only some telehealth flexibilities have been extended through 2024, while others have simply expired. For example, face-to-face encounters for hospice recertification can still be conducted via telehealth, while telehealth visits for routine home care have expired.

Future of Hospice and Palliative Medicine

This transitionary period will be challenging as the world moves back out of the fog that was the pandemic. The industry has adapted, evolved, and now hospice and palliative providers must ensure continuity of care as they navigate sweeping changes. This includes finding ways to keep the innovations like telehealth services that were crucial during the pandemic and integrating them into how we deliver adequate care through hospice and palliative services.

For guidance in navigating the post-COVID PHE landscape within hospice and palliative medicine, contact our healthcare professionals for a consultation. We’ll be more than happy to help you every step of the way.

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