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Home Care and Hospice Regulatory Waiver Guidance Now Available

The state Department of Health (DOH) posted a Dear Administrator Letter(DAL) that provides an update on home care and hospice regulatory waivers that were issued during the COVID-19 pandemic.

The DAL is available on the DOH home care website.

The DAL notes that the COVID-19 State of Emergency in New York ended on June 25, 2021 and addresses the resumption of routine services for home care and hospice agencies, and under what limited circumstances DOH will continue to exercise ‘enforcement discretion’ in recognition that providers need time to restart and complete activities previously suspended.

Providers are advised to immediately initiate efforts to restart activities and be able to demonstrate to DOH surveyors that there is a plan in place for compliance as soon as practicable.

The DAL addresses the following areas:

  • Supervision of home care aides
  • In-Home Initial Assessments and Reassessments
  • Annual Performance Evaluations
  • Pre-Employment Health Assessments for New Employees and Annual Health Assessments
  • Supervised Practical Training
  • In-Service Training for Personal Care, Home Health and Hospice Aides
  • Home Care Aide Training Program Completion and Submission of Schedules
  • Alternative Competency Demonstration for Personal Care Aides

Please note that as it relates to hospice, the DAL mentions that the U.S. Centers for Medicare and Medicaid Services (CMS) has waived the requirement that hospice aides receive at least 12 hours of annual training. CMS has modified the regulation that requires hospices to annually assess the skills and competence of all individuals furnishing care and provide in-service training and education when required. Specifically, CMS postponed the annual assessment requirement until the end of the first full quarter following the declaration of the end of the federal PHE. HCA is verifying how these federal waivers currently affect hospices in New York State. 

HCA has communicated with DOH, the Legislature and the Executive and has sent regulatory relief recommendations to the state’s key decision-makers. HCA is still reviewing this DAL to determine which relief measures need any further action and which have not been addressed. HCA will continue to monitor all state and federal guidance related to regulatory relief and communicate updates with the membership as more is learned.

Questions related to the exceptions and/or practices should be addressed to or to

Providers may also contact Andrew Koski or Alyssa Lovelace.