McKnight's Long-Term Care News, March 2019, page 3, Seema Verma

Nearly 26,000 residents and 450 workers in U.S. nursing homes have died from COVID-19, federal authorities announced Monday afternoon while also declaring they would be increasing penalties for non-compliant providers. 

Overall, more than 60,000 residents and 34,400 workers have gotten sick in the U.S., according to figures released by the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention.

The numbers represent just partial accounting under the federal agencies’ new reporting scheme. Figures for residents and workers are expected to climb significantly. Numbers will be updated later this week and posted for the public to peruse, CMS Administrator Seema Verma said.

“While many nursing homes have performed well and demonstrated that it’s entirely possible to keep nursing homes patients safe, we are outlining new instructions for state survey agencies and enforcement actions for nursing homes that are not following federal safety requirements,” Verma said in a statement released shortly before addressing reporters Monday afternoon.

The agencies reported the numbers earlier to the nation’s governors.

“This data, and anecdotal reports across the country, clearly show that nursing homes have been devastated by the virus,” wrote CDC Director Robert Redfield and Verma to the governors in a letter dated Sunday.

According to that missive, the numbers reflect data submitted as of a week ago (May 24) — from about 80% of the nation’s roughly 15,400 nursing homes. Roughly one in four nursing homes had at least one COVID-19 infected patient and one in five had at least one death.

CMS said it is toughening penalties based on the early COVID-19 data trends, as well as on findings of the agency’s targeted infection control inspections.

The agency said it will increase fines for providers that consistently perform poorly in infection control measures. Additionally, the agency will start imposing enforcement actions on lower level deficiencies “to ensure they are addressed with increased gravity.”

CMS will start posting the CDC-collected COVID-related data on the consumer-facing Nursing Home Compare website starting Thursday. Results will be broken down by state, number of residents and number of staff.

States are also in CMS’s crosshairs. Those that do not complete 100% of their focused infection control surveys by July 31 will be required to submit corrective plans of action within 30 days. Those that are still not at a 100% level after 30 days could see a 10% reduction of CARES Act 2021 funding. Further 30-day non-compliant periods could produce additional 5% reductions. Collected funds will be distributed among states that have completed all of their focused surveys.

Some states have met the 100% goal already, but the overall average is just over 54%, with at least one as low as 11%.

The leader of the nation’s largest nursing home association said the death totals announced today confirm what the industry has been saying for months: nursing homes are in an unprecedented, no-win situation.

“[W]e should anticipate the number of cases to rise as asymptomatic residents and staff will be identified,” as testing increases, explained American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson in a statement. “While an increase in these reported numbers may be startling, it will improve our ability to confront this threat and protect our residents.”

He also warned against extra punitive actions.

“This situation will get worse if surveyors are only looking for reasons to find deficiencies and issue fines instead of identifying ways for nursing homes to make real changes and help them improve their infection control programs,” Parkinson said. “It’s time to recognize that when nursing homes receive citations, it’s a failure not just of the provider, but of CMS and the survey process as well. Citations and fines without assistance will not help us keep residents and staff safe from this virus.”

This is a developing story. Check back for updates.