The Centers for Medicare & Medicaid Services (CMS) has announced some actions that healthcare providers, including nursing homes, need to take immediately to confront the threat of the coronavirus (COVID-19) that is occurring in many countries around the world.
CMS is instructing the numerous state survey agencies and accrediting organizations to focus their inspections of facilities “exclusively on issues related to infection control and other serious health and safety threats, like allegations of abuse-beginning with nursing homes and hospitals.”
The first memorandum CMS has issued contains details regarding its direction on the “temporary focus of surveys on infection control and other emergent issues.” Also, it should be noted that statutorily required surveys will continue and be guided by the following regime:
- All immediate jeopardy complaints (a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death or harm) and allegations of abuse and neglect;
- Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses;
- Statutorily required recertification surveys (Nursing Home, Home Health, Hospice, and ICF/IID facilities);
- Any re-visits necessary to resolve current enforcement actions;
Initial certifications; - Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years;
- Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.
The first memorandum includes protocols for the inspection process in situations in which COVID-19 is identified or suspected. Other memoranda provide critical answers to common questions that nursing homes and hospitals may have with respect to addressing cases of COVID-19. For example, the memoranda discusses concerns like screening staff and visitors with questions about recent travel to countries with known cases, and the severity of infection that would warrant hospitalization instead of self-isolation.
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes may be found at:
https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/guidance-infection-control-and-prevention-coronavirus-disease-2019-covid-19-nursing-homes
Compliance Perspective
Failure to have a comprehensive Infection Prevention and Control Plan in place, including an Infection Preventionist who ensures that the program protocols are carried out when confronting what has been determined to be a serious threat to all persons, especially elderly and frail residents in nursing homes, may be considered abuse and neglect and deemed provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points
- Review policies and procedures to ensure compliance with CMS infection control requirements and guidelines from the Centers for Disease Control and Prevention (CDC).
- Train staff on the importance of handwashing and following the protocols of the facility’s Infection Prevention and Control Program, with emphasis on how to use protective equipment (masks, gowns, etc.)
- Periodically audit to determine if the facility’s Infection Prevention and Control Program is implemented, and if staff and residents are practicing important handwashing protocols.
