CMS Activates Emergency Waivers for Washington Nursing Homes as Wildfires Force Evacuations

Spokane, Washington — Nursing homes and other long-term care facilities in Washington state are getting federal breathing room as wildfires continue to tear through the region. The Centers for Medicare & Medicaid Services announced a sweeping set of blanket waivers and flexibilities retroactive to August 1, designed to keep care running for thousands of displaced residents.

The Fairview, Autumn Lane, and Old Trails fires near Spokane County have forced evacuations across the area, leaving facilities scrambling to maintain operations while managing resident transfers and staff shortages. HHS Secretary Robert F. Kennedy Jr. declared a public health emergency on August 7, unlocking the federal authorities CMS needed to act.

What the Waivers Cover

CMS is offering several key flexibilities for affected providers. Healthcare facilities can submit requests for specific emergency waivers through the agency’s 1135 waiver system. The blanket waivers apply retroactively from August 1, meaning facilities that already took emergency steps won’t face penalties for deviating from normal requirements.

For nursing home residents who rely on dialysis, CMS activated its Kidney Community Emergency Response program. ESRD Network 16 is coordinating with facilities to assess generator supplies, alternate water sources, and patient education materials. The network’s toll-free hotline — 1-800-232-3773 — is fielding calls from displaced patients who need to locate functioning dialysis centers.

Equipment and Medication Access

Beneficiaries who lost durable medical equipment in the fires can get replacements covered by Medicare. The agency is also clearing red tape around prescription refills. Part D plans must remove “refill too soon” edits for displaced enrollees and reimburse beneficiaries who pay out-of-network for emergency medication needs.

The flexibilities extend to privacy rules as well. Hospitals that implement disaster protocols can get temporary relief from certain HIPAA sanctions for up to 72 hours, allowing faster information sharing with emergency responders and family members trying to locate loved ones.

Why It Matters

Wildfires pose unique challenges for nursing homes. Unlike hospitals, most long-term care facilities aren’t designed for rapid evacuation of non-ambulatory residents. Many patients require oxygen, specialized diets, or wound care that can’t easily transfer to emergency shelters. The financial pressures facing operators have already stretched staffing thin in rural Washington, making emergency response even harder.

CMS said it will continue working with state officials and federal partners as the situation develops. Facilities needing specific flexibilities can submit requests through the agency’s online portal.