The CARES Act includes a provision for the US Government Accountability Office (GAO) to conduct monitoring and oversight of the federal government’s effort to prepare for, respond to, and recover from the COVID-19 pandemic. The GAO has concluded that the Department of Health and Human Services (HHS) has taken steps to address COVID-19 in nursing homes, but that HHS has not implemented several relevant GAO recommendations.
The GAO’s review of data from the Centers for Disease Control and Prevention (CDC) found that winter 2020 was marked by significant surge in the number of COVID-19 cases and deaths in nursing homes; however, CDC data as of February 2021 shows that both cases and deaths have declined by more than 80% since their peaks in December 2020.
The GAO has found that HHS, primarily through the Centers for Medicare & Medicaid Services (CMS) and the CDC, has not implemented several relevant GAO recommendations that include:
- HHS has not implemented GAO’s recommendation related to the Nursing Home Commission report, which assessed the response to COVID-19 in nursing homes. CMS released the Nursing Home Commission’s report and recommendations in September 2020. When the report was released, CMS broadly outlined the actions the agency had taken, but the agency did not provide a plan that would allow it to track its progress. GAO recommended in November 2020 that HHS develop an implementation plan. As of February 2021, this recommendation had not been implemented.
- HHS has not implemented GAO’s recommendation to fill COVID-19 data voids. CMS required nursing homes to begin reporting the number of cases and deaths to the agency effective May 8, 2020. However, CMS made the reporting of the data prior to this date optional. GAO recommended in September 2020 that HHS develop a strategy to capture more complete COVID-19 data in nursing homes retroactively back to January 1, 2020. As of February 2021, this recommendation had not been implemented.
The GAO concludes that by implementing these recommendations, it could help address some of the challenges nursing homes continue to face and fill important gaps in the federal government’s understanding of, and transparency around, data on COVID-19 in nursing homes. Read the full GAO report here.
Compliance Perspective
Issue
The pandemic has brought many new challenges to nursing facilities across the country. Government agencies have increased their scrutiny of care and services provided by nursing facilities during the pandemic to the extent we have not seen in the past. It is critical that emergency preparedness and infection control plans are up-to-date and implemented fully.
Discussion Points
- Review your emergency preparedness and infection control plans. Ensure that they include the most up-to-date information available by credible sources. Update your plans as necessary.
- Train all staff on your emergency preparedness and infection control plans. Document that these trainings occurred and file the signed document in each employee’s education file.
- Periodically audit staff understanding of your emergency preparedness plan and ensure that they are following infection control guidance as outlined in your protocols. Provide additional training as deemed necessary based on audit findings.
