Nursing home operators were left shaking their heads and criticizing the Trump administration over the weekend after the latter touted larger than usual numbers of serious citations and fine amounts against skilled nursing providers during the pandemic.
The Centers for Medicare & Medicaid Services announced Friday afternoon that it had levied more than $15 million in fines to nursing homes since March. In addition, federal regulators noted that they had tripled the number of Immediate Jeopardy citations, the most severe possible, during the same span.
“Fines are not the answer,” said Katie Smith Sloan, president and CEO of LeadingAge, in a statement emailed to McKnight’s. “We need help and collaboration from CMS. A punitive approach is unsustainable.”
She noted that several respected academic studies have shown that COVID-19 spread in the greater surrounding community is a leading predictor of how much the virus will spread in a nursing home..
“[M]embers are paying tens of thousands of dollars — millions, in some cases — for PPE, tests, and other pandemic-related expenses,” she noted.
Mark Parkinson, the president and CEO of the American Health Care Association, emphasized the same point about community spread and how it can lead to COVID-19 outbreaks in even the best-performing nursing homes.
“ … the evidence clearly shows that even the best nursing homes with the most rigorous standards cannot stop this highly contagious and invisible virus,” Parkinson said in a statement to McKnight’s. “Our focus should be on getting a handle on the amount of spread in the surrounding community and prioritizing nursing homes for ongoing resources.”
He urged “a more collaborative approach to addressing this once-in-a-century, global crisis.”
“Nursing homes cannot beat this pandemic alone, and focusing on enforcement and penalties only takes precious resources away at this critical time,” he noted. “Providers need the support of public health officials to prioritize our residents and help facilities acquire the necessary resources.”
CMS announced the large fine and IJ citation numbers a day after Administrator Seema Verma had assured providers on a conference call, “We are here to help you and support you. This isn’t a time of fines and being punitive. It is a time … to be problem solvers. I want you to know that whatever you need, we are here to help you on any level, whether it’s staffing, supplies, testing, technical assistance, we’re here to get you whatever you need.”
It was also on that call, however, that Verma also explained that providers, overall, had not been performing well enough on infection control matters, causing “deep concern” among regulators.
More than 3,400 nursing homes had been cited for noncompliance with infection control requirements or failure to report COVID-19 data, CMS announced Friday. More than $15.5 million in penalties had been levied against providers.
On Thursday, AHCA released results of a member survey that showed more than 70% of them could not sustain services if the same operating conditions persisted for the next 12 months, with 40% saying the same for just the next six-month period.