Self-reporting raises doubts

In new but anticipated guidance released Sunday night, the Centers for Medicare & Medicaid Services is requiring nursing homes to report any COVID-19 cases directly to the Centers for Disease Control and Prevention. It also is mandating that facilities notify residents and families of all COVID cases — or risk enforcement actions. 

“Nursing homes have been ground zero for COVID-19,” said CMS Administrator Seema Verma in a media release Sunday night. “Today’s action supports CMS’ longstanding commitment to providing transparent and timely information to residents and their families. Nursing home reporting to the CDC is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”

CMS noted that the CDC will be providing a reporting tool to nursing homes that will “support Federal efforts to collect nationwide data to assist in COVID-19 surveillance and response.” It also pointed out that the effort builds on reporting recommendations issued last week by the  American Health Care Association and LeadingAge, the two biggest U.S. nursing home associations. 

Prior to Sunday’s guidance regarding the CDC, nursing homes have been required to report suspected and confirmed cases of COVID and residents and staff with serious respiratory ailments to local and state health departments. 

Notifying residents and families

In related guidance issued Sunday that “is separate from the reporting required to CDC,” CMS is requiring that nursing homes inform residents and their representatives of conditions at the facilities. CMS noted that rulemaking on this guidance will follow the Sunday memorandum. 

As part of this new reporting mandate, “nursing homes must inform residents and their representatives within 12 hours of the occurrence of a single confirmed infection of COVID-19, or three or more residents or staff with new-onset respiratory symptoms that occur within 72 hours.” 

CMS said that failure to report resident or staff incidences of infection, including confirmed COVID-19 cases, or provide timely notification to residents and families “could result in an enforcement action.”

Pressure mounting

CMS said last week that guidance would be forthcoming related to reporting requirements. As the death toll mounts in nursing homes throughout the country, facilities are facing a barrage of pressure from lawmakers and families to provide more information and transparency related to COVID cases. 

AHCA and LeadingAge initially fueled the push for reporting, arguing that, in order to fight the virus effectively, nursing homes must receive adequate personal protective equipment and test kits. In the push to provide needed resources to hospitals, AHCA CEO and President Mark Parkinson said that nursing homes “feel like we’ve been forgotten.”