The state of Mississippi leads the nation in the number of COVID-19 cases per capita for nursing home residents. Outbreaks this past week increased by almost 25%, and 140 of the state’s facilities have at least one case among the residents and two or more cases among staff members in a one-week period. Mississippi is also reported to have the fifth highest COVID-19 death rate among its nursing homes.
The Mississippi State Department of Health (DOH) stopped reporting on outbreaks by facility in September and started relying on Medicare data to track its nursing homes’ outbreak data at that time. Duplicate reporting was cited as the reason for the change; however, the DOH indicated it was still tracking active and cumulative outbreaks by county.
Recent national reporting revealed that 10 of Mississippi’s nursing homes did not submit data, and of the facilities that did, nine did not pass the “quality assurance” test, causing the data to be considered unreliable. Because about 10% of Mississippi’s nursing homes’ COVID-19 data is deemed unreliable, the rate of cases among residents is undeterminable.
Many of the state’s facilities report shortages of personal protective equipment (PPE), but only nine reported testing issues. Despite the Centers for Disease Control and Prevention (CDC) testing recommendation, less than one-fourth of the state’s nursing homes report testing all staff and residents after a new case arises.
Although many consider surveillance testing as the most effective way to evaluate actual case burden and isolate the spread of COVID-19, only 80 facilities (about one-third) test residents without exposure. Notably, the DOH tested all nursing home staff and residents last May, and successfully prevented the growing spread of the Coronavirus at that time.
Nursing shortages were also reported in one-fourth of the nursing homes, and 10% reportedly do not have at least a week’s supply of N-95 masks. These shortages tend to underscore the long-standing strain on resources that have interfered with a facility’s ability to control the spread of the Coronavirus among residents and staff members.
Compliance Perspective
Issue
Facilities that do not accurately track and report outbreaks of COVID-19 and do not follow CDC’s testing recommendations may be considered noncompliant with the Centers for Medicare & Medicaid Services (CMS) regulations. This may be deemed as placing residents in jeopardy for harm, provision of substandard quality of care, and violation of state and federal regulations.
Discussion Points
- Review policies and procedures regarding CMS required tracking and reporting of COVID-19 to the CDC, and its recommended guidelines for testing. Additionally, the facility may need to evaluate the level of PPE available for addressing the increasing numbers of COVID-19 outbreaks.
- Train staff on accurately documenting data for tracking and reporting COVID-19 cases, along with maintaining infection control protocols.
- Periodically audit to determine if staff and residents are being tested according to the CDC guidelines, and whether the facility has an adequate supply of PPE, including N-95 masks.
FOR MORE INFORMATION ON THIS TOPIC view: COVID-19 FACILITY PREPAREDNESS SELF-ASSESSMENT.
