CMS Suspends Nursing Home Inspections, Offers Guidance in Wake of Coronavirus

The Centers for Medicare & Medicaid Services (CMS) is suspending non-emergency inspections of nursing homes so inspectors can focus on the spread of the coronavirus (COVID-19).  CMS also announced guidance for controlling COVID-19 in nursing homes.

CMS announced March 4 that, effective immediately, it will conduct only the following survey inspections, in order of priority:

• Immediate jeopardy complaints and allegations of abuse and neglect,

• Infection control concerns, including COVID-19 or other respiratory illnesses,

• Statutorily required recertification surveys,

• Re-visits necessary to resolve enforcement actions,

• Initial certifications,

• Surveys of facilities or hospitals with a history of infection control deficiencies at the immediate jeopardy level in the last three years, and

• Surveys of facilities, hospitals or dialysis centers with a history of infection control deficiencies at levels below immediate jeopardy.

Details of the announcement, as well as surveyor guidance on COVID-19 and infection control, can be found at https://www.cms.gov/files/document/qso-20-12-allpdf.pdf-1.

The CMS guidance for controlling COVID-19 in nursing homes can be found at https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/qso-20-14-nh.pdf.  The guidance encourages nursing homes to monitor the Centers for Disease Control (CDC) web page devoted to information and resources regarding COVID-19 located at https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/index.html.

Some specific provisions of the CMS guidance include:

• Screening visitors for the following, in which case nursing homes may restrict entry:

  • International travel in the prior 14 days to restricted countries (listed at https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html),

  • Signs or symptoms of a respiratory infection, and

  • Contact with someone with or under investigation for COVID-19.

• Screening staff for the same criteria listed above. Staff who have signs or symptoms of a respiratory infection should not report for work, and staff who develop such signs or symptoms should immediately self-isolate at home and inform the facility and the local health department.

• Nursing homes with residents suspected of having COVID-19 should contact the local health department.

• A nursing home can accept a resident diagnosed with COVID-19 from a hospital if it can follow CDC guidance for transmission-based guidance.

In addition, CMS recommends that nursing homes contact their local health department if they have questions or suspect a resident has COVID-19, consider frequent monitoring for respiratory infection, and use CDC and CMS resources for training and preparing staff on infection control.  Further guidance and resources are at the CMS guidance link provided above.