1. (a) In the event of a public health emergency, natural disaster, other major emergency, or severe labor shortage, the Department of Human Services may temporarily waive the average direct care hours per resident day standard in 20 CAR §§ 400-1404 and 400-1405 for any certified facility in a county or the state.

2. (b) In the event of a public health emergency, a natural disaster, or other emergency declared by the Governor or the United States Secretary of Health and Human Services, the Department of Human Services may issue a temporary waiver or variance of any rule, including any staffing-related rule, that it determines reasonable and necessary under one (1) or more of the following circumstances:

   1. (1) For licensed nursing facilities and ICFs-IID to:

      1. (A) Provide resident care;
      2. (B) Protect the health and safety of:

3. (i) Residents;

   1. (ii) Staff; and

      1. (iii) Visitors;
      2. (C) Meet staffing needs;
      3. (D) Meet new federal requirements or guidance;

      4. (E) Coordinate care delivery and emergency response with:

         1. (i) Hospitals;
         2. (ii) Physicians;
         3. (iii) Other providers; and
         4. (iv) Public health or emergency management authorities; or

      5. (F) Adopt alternative:

         1. (i) Staffing;
         2. (ii) Practices;
         3. (iii) Procedures; or
         4. (iv) Technology; or

   2. (2) In response to any federal waiver or requirement modification issued under:

      1. (A) 42 U.S.C. § 1320b–5;
      2. (B) 42 C.F.R. pt. 483; or

      3. (C) Other federal authority.

         1. (c)
   3. (1) A request for a waiver or variance must be made in writing by a licensed nursing facility to the Director of the Division of Provider Services and Quality Assurance.

   4. (2) The request must contain:

      1. (A) Details of the reason for the waiver or variance; and

      2. (B) The potential impact to the facility if said waiver or variance is not granted.

         1. (d)
   5. (1) The Department of Human Services may approve or deny a waiver or variance request at its discretion.
   6. (2) Approvals and denials must be made in writing.

4. (e) The Department of Human Services may extend or renew an approved waiver or variance and may impose such conditions it deems necessary to:

   1. (1) Protect the health and safety of facility residents and staff;
   2. (2) Meet federal requirements or guidance; or
   3. (3) Best meet the intended purpose of the waiver or variance.

Codification Notes: “IID” means individuals with intellectual disabilities.