Providers struggling to comply with infection control requirements could be looking at fines of up to $20,000 under increased enforcement efforts announced Monday by the Centers for Medicare & Medicaid Services in the wake of the coronavirus pandemic.
“We’re ratcheting up penalties with non-compliance to infection control,” CMS Administrator Seema Verma said on a call with reporters Monday. “The fines are more significant for nursing homes with a history of past infection control deficiencies.”
Fines increase for providers that consistently perform poorly on infection control measures, according to CMS. Per a CMS memo, the fines are up to $5,000 for a provider found not in compliance with infection control requirements that’s also been cited once in the last year if the deficiencies are not widespread. If the deficiencies are widespread, the provider would face a fine of up to $10,000.
The fines go higher from there — up to $15,000 for providers that have been cited twice or more in the last two years and found non-compliant with infection control regulations where deficiencies are not widespread. The fines can reach $20,000 in that same situation if the infection control deficiencies are widespread.
Provider groups expressed concern with the government’s new penalties. The increased enforcement is an effort by the federal government to “punish its way out of the pandemic,” LeadingAge, the association of mainly nonprofit providers, said in a statement.
“Nursing homes should be held accountable when they fall short, but escalating threats of punishment will not change the outcomes for vulnerable adults if providers are still left without the tools they desperately need,” LeadingAge President and CEO Katie Smith Sloan said.
Mark Parkinson, the leader of the American Health Care Association, the nation’s largest nursing home association, also warned against the effect of 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.”
CMS’s announcement of enhanced enforcement for infection control deficiencies is based on early COVID-19 trends, which revealed that about 26,000 residents and 450 workers in U.S. nursing homes have died from the disease. Additionally, more than 60,000 residents and 34,400 workers have gotten sick from the coronavirus.
Infection control has been a major focus for providers and regulators during the public health crisis. Verma said she doesn’t see the federal government rolling back additional regulations anytime soon.
“I don’t see us moving back on our infection control guidelines. Those are longstanding. They not only apply to COVID virus but they apply to any potential infection, whether it’s the flu or anything else,” she said.
The agency also urged governors to complete focused infection control surveys at each of its nursing homes by July 31. If they don’t, they could see a reduction in CARES Act funding, she said. Verma said the focused effort on the part of the state’s is “critical” to preventing the spread of the virus and potential resurgences.
Initial data released by CMS and the Centers for Disease Control and Prevention also revealed that star ratings correlate to the spread of the coronavirus in facilities.
“Early analysis shows that the facilities with a one-star rating were more likely to have large numbers of COVID cases than facilities with a five-star rating,” Verma said.
That contradicts findings from a University of Chicago analysis, which indicated that there was no meaningful relationship between a nursing homes’ Five Star Rating and the probability of it having at least one COVID019 case or death.