Editor’s note: This column is in response to the provider-authored guest blog “Stolen valor” posted here Wednesday.
We thank McKnight’s Long-Term Care News for allowing us an opportunity to correct the record, as the op-ed to which we’re responding is full of inaccurate information.
Over a year ago, even before the first outbreak in Washington state, the Centers for Medicare & Medicaid Services provided resources and alerted nursing homes to improve their infection control practices.
In March 2019, CMS updated training in infection prevention for nursing homes. In November 2019, CMS reminded nursing homes of the infection prevention requirements, and disseminated an infection control self-assessment tool. Then, on February 6, 2020 in preparation for COVID-19 spread in the U.S., CMS reissued long-standing infection control guidance. We also provided nursing homes with infection control training for frontline staff. The record clearly demonstrates CMS was at the forefront of alerting our nursing homes to be ready for COVID-19, and any suggestion that CMS was delayed or “lagged behind,” is unequivocally false and misinformed.
The infection control practices CMS reemphasized for nursing homes were not new; they have been part of CMS’s regulatory expectations for years. In fact, two years ago, CMS urgently alerted the nursing home industry that they “have to do better on infection control,” a message that was carried in this very periodical. Infection control — including basic violations like a lack of handwashing — was the number one violation.
Since the beginning of the COVID-19 pandemic, CMS has kept up a steady drumbeat of guidance and recommendations to nursing homes and other kinds of healthcare providers based on CDC and CMS COVID-19 investigations and surveys. Following our Feb. 6, 2020, guidance, we called for screening of staff and visitors, followed soon thereafter by a complete restriction of nonessential visitors and staff. All of this guidance, created in coordination with the CDC and based on the latest information, helped approximately 80% of nursing homes prevent the spread of COVID-19.
CMS is not blaming nursing homes for COVID-19 outbreaks and we’re not aiming to be punitive, but are aiming to protect our most vulnerable. We know that a case of any infectious disease does not necessarily indicate noncompliance with our regulations.
At the same time, we also know that when nursing homes have a history of infection control violations, they are at higher risk of the spread of infectious diseases like COVID-19. Therefore, we’ve decided to hold nursing homes more accountable for the kinds of infection control violations that can help infectious diseases like COVID-19 spread. Given that these requirements are longstanding, there is simply no excuse for continued noncompliance.
But we know that it’s important for nursing homes to have the tools they need to perform better. So we’ve ramped up the technical assistance we provide to nursing homes to help them implement proper infection control practices. Through our Quality Improvement Organizations, we’ve created a toolkit that has received high praise from governors across the country, who have thanked CMS for compiling best practices for facilities in their states. This toolkit is updated every two weeks, as new information comes in from around the country.
Finally, we have repeatedly thanked the frontline healthcare providers who are fighting COVID-19. I am immensely proud of them, as well as the public servants at CMS, who have worked literally around the clock at unprecedented speed, to ensure that the entire healthcare system has the flexibilities and guidance it needs to safely and effectively meet the healthcare needs of Americans during this pandemic.
But we’re not done. As America reopens, our commitment to nursing home residents is as strong as ever, and we’re redoubling our efforts to keep them safe. We urge the entire nursing home industry to join us in this effort because residents deserve nothing less.
Seema Verma is the administrator of the Centers for Medicare & Medicaid Services.
