NEWS ALERT: CMS Issues New Guidance on COVID-19 Notification Requirements for Nursing Homes

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Original story posted on: May 7, 2020

Long-term care facilities nationwide have been particularly hard-hit by the viral pandemic.  

The Centers for Medicare & Medicaid Services (CMS) has released a memo and FAQ sheet in advance of an interim final rule, expected to be released on Friday, that will update notification requirements for confirmed and suspected COVID-19 cases among residents and staff in nursing homes nationwide.

CMS will now require such facilities to report COVID-19 data to the Centers for Disease Control and Prevention (CDC), as well as to nursing home residents, their representatives, and residents’ families. The move comes a little less than three weeks after a preliminary memo gave notice of the coming changes. 

Prior to the global viral pandemic, federal regulations had already required long-term care centers – skilled nursing facilities (SNFs) and other nursing facilities – to have written standards, policies, and procedures regarding infection control. But in an effort to “support surveillance of COVID-19 cases and increase transparency,” according to CMS’s memo, those requirements are being expanded.

Specifically, each such facility must:

  • Electronically report information about COVID-19 in a standardized format specified by the U.S. Department of Health and Human Services (HHS) Secretary, with reported information including but not limited to:

    • Suspected and confirmed COVID-19 infections among residents and staff;
    • Ventilator capacity and supplies in the facility;
    • Resident beds and census;
    • Access to COVID-19 testing while residents are in the facility;
    • Any staffing shortages;
    • Residents previously treated for COVID-19;
    • Total deaths and COVID-19 deaths among residents and staff;
    • Personal protective equipment (PPE) and hand hygiene supplies in the facility; and
    • Any other information specified by the HHS Secretary.
  • Provide this information at a frequency specified by the Secretary, but no less than weekly, to the CDC’s National Healthcare Safety Network. This information will be posted publicly by CMS to support protecting the health and safety of residents, personnel, and the general public.
  • Inform residents, their representatives, and families of those residing in facilities by 5 p.m. the next calendar day following the occurrence of either a single confirmed infection of COVID-19, or three or more residents or staff with new onset of respiratory symptoms occurring within 72 hours of each other.

This information also must not include personally identifiable information; must include information on mitigating actions implemented to prevent or reduce the risk of transmission, including whether normal operations of the facility will be altered; and must include any cumulative updates for residents, their representatives, and families at least weekly or by 5 p.m. the next calendar day following the subsequent occurrence of either each time a confirmed infection of COVID-19 is identified, or whenever three or more residents or staff have new onset of respiratory symptoms occur within 72 hours of each other.

“We understand that state and local health departments may currently require nursing homes to report certain COVID-19 related information to them,” the CMS memo added. “A key difference between the state/local reporting and this new national reporting requirement is that reporting to state/local health departments allows them to understand the status of their local environment and intervene (e.g., direct staffing and supplies), whereas this national requirement provides standardized information to assist with national surveillance on the status of COVID-19 in all nursing homes.”

COVID-19 has had a “disproportionate effect” on long-term care facilities, according to a recent Kaiser Family Foundation (KFF) report, which outlined the nonprofit organization’s data collection effort that found that in the 23 states that previously reported health data, as of April 23, there had been more than 10,000 COVID-19 deaths in such locations nationwide, representing 27 percent of the total number of COVID-19 deaths. In six of the 23 states (Colorado, Delaware, Massachusetts, Oregon, Pennsylvania, and Utah), deaths in long-term care centers accounted for more than half of all deaths.

The KFF report further noted that more than 2 million Americans live in long-term care facilities, with an additional 3 million working in them.

As of Wednesday, the global COVID-19 pandemic had reportedly infected nearly 3.7 million people around the world, including approximately 1.2 million Americans, more than 70,000 of whom have died.

To read CMS’s new memo and FAQs in their entirety, go online to https://www.cms.gov/files/document/qso-20-29-nh.pdf.

Mark Spivey

Mark Spivey is a national correspondent for RACmonitor.com, ICD10monitor.com, and Auditor Monitor who has been writing and editing material about the federal oversight of American healthcare for more than a decade. He can be reached at mcspivey@hotmail.com.

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