Resources

Home health and hospice agencies may be eligible for certain waivers and flexibilities if their agency operates in affected disaster areas of Texas.

 In response to the 2025 Texas severe storms, straight-line winds, and flooding, the Secretary of Health and Human Services declared a Public Health Emergency (PHE) effective July 2, 2025 and CMS has waivers available for Texas health care providers in the affected counties. These waivers and other flexibilities are in effect through the end of the Texas flooding PHE declaration of Texas signed 07/08/2025, retroactively from 07/02/2025, or when no longer needed. Despite the availability of blanket waivers, suppliers and providers should strive to return to their normal practice as soon as possible.

Summary of hospice and home health agency waivers include:

• Hospice comprehensive assessments- CMS is waiving certain requirements at 42 CFR §418.54 related to updating comprehensive assessments of patients. This waiver applies the timeframes for updates to the comprehensive assessment found at 42 CFR §418.54(d). Hospices must  continue to complete the required assessments and updates; however, the timeframes for updating the assessment may be extended from 15 to 21 days.
• Home health initial assessments- CMS is waiving the requirements at 42 CFR §484.55(a) to allow home health agencies to perform Medicare-covered initial assessments and determine patients’ homebound status remotely or by record review. This will allow patients to be cared for in the best environment for them while supporting infection control and reducing impact on acute care and long-term care facilities and allow clinicians to focus on caring for patients with the greatest acuity.
• Home health initial and comprehensive assessments for all patients- CMS is waiving the requirements in 42 CFR §484.55(a)(2) and §484.55(b)(3) that rehabilitation skilled professionals may only perform the initial and comprehensive assessment when only therapy services are ordered. This temporary blanket waiver allowed any rehabilitation professional (OT, PT, or SLP) to perform the initial and comprehensive assessment for all patients receiving therapy services as part of the plan of care, to the extent permitted under state law, regardless of whether or not the service establishes eligibility for the patient to be receiving home care.
• Home health reporting- CMS is providing relief to home health agencies on the timeframes related to OASIS Transmission through the following actions below:
1. Extending the 5-day completion requirement for the comprehensive assessment to 30 days.
2. Modifying the 30-day OASIS submission requirement. Delayed submission is permitted during the PHE.
• Hospice and home health supervision of aides- CMS is waiving the requirements at CFR §418.76(h)(1) and CFR §418.76(h)(2) for hospice and 42 CFR §484.80(h)(1) for home health agencies, which require a nurse to conduct an onsite visit every two weeks. This would include waiving the requirements for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan, as this may not be physically possible for a period of time. This waiver is also temporarily suspending the two-week aide supervision by a registered nurse for home health agencies’ requirement at §484.80(h)(1), but virtual supervision is encouraged during the period of the waiver. All postponed annual onsite assessments (direct observation) for each aide that provides services on behalf of the agency must be completed by these professionals no later than 60 days after the expiration of the PHE.

Refer to these links for further information:

CMS- https://www.cms.gov/files/document/standard-waiver-list-texas-severe-storms-flooding-updated-07-14-25.pdf.

FEMA designated disaster areas- https://www.fema.gov/disaster/4879/designated-areas

Administration for Strategic Preparedness & Response- https://aspr.hhs.gov/legal/PHE/Pages/Texas-Floods-8Jul2025.aspx