Long-term care providers on Monday said they appreciate a decision by the Centers for Medicare & Medicaid Services to limit surveys of nursing homes and other providers for a three-week period in the wake of the coronavirus public health crisis.
In a new memo, CMS said that it will conduct the following surveys over the next three weeks:
• Complaint/facility-reported incident surveys involving Immediate Jeopardy
• Targeted infection control surveys
• Self-assessments
All of the above will include intensified scrutiny of infection control practices in light of rising fears over the spread of the novel coronavirus.
“We commend CMS’ decision today to limit surveys for a three-week period in a redoubling of efforts to prevent and contain coronavirus spread within nursing homes,” said Katie Smith Sloan, president and CEO of LeadingAge, which represents nonprofit providers. “This is urgent — an all-hands-on-deck moment. CMS is a partner in helping us to curb the spread of this deadly scourge.”
The American Health Care Association said it’s reviewing the full memo.
“Our members appreciate the opportunity to focus all of their energy and resources on preventing the spread of COVID-19. We want to emphasize that surveyors should not perform an onsite survey and refrain from entering the building if there is a lack of appropriate PPE supplies,” the association told McKnight’s Long-Term Care News Monday.
CMS said that it will not conduct the following surveys over the next three weeks:
• Standard surveys for nursing homes, hospitals, home health agencies, intermediate care facilities for individuals with intellectual disabilities, and hospices.
• For Clinical Laboratory Improvement Amendments (CLIA), it intends to prioritize immediate jeopardy situations over recertification surveys, and generally intends to use enforcement discretion, unless immediate jeopardy situations arise.
• Initial certification surveys will continue to be authorized in accordance with current guidance and prioritization.
CMS noted that the president declared a national emergency on March 13, which triggers the Department of Health and Human Services secretary’s ability to authorize waivers or modifications of certain requirements pursuant to section 1135 of the Social Security Act.
“Under section 1135(b)(5) of the Act, CMS is prioritizing surveys by authorizing modification of timetables and deadlines for the performance of certain required activities, delaying revisit surveys, and generally exercising enforcement discretion for three weeks,” CMS wrote.
Inspection: Washington SNF didn’t act fast enough
The updated guidance comes on the heels of a preliminary inspection that found that Life Care Center of Kirkland in Washington state acted slowly in response to the coronavirus outbreak. Kirkland was the first site of an outbreak in the U.S.
The investigation concluded that the facility didn’t act quickly enough to identify and manage ill residents, notify the state’s health department about the increasing rate of respiratory infections among residents and didn’t have a “sufficient backup plan” after its primary clinician became ill.
More than 80 residents, 34 staff members and 14 visitors have tested positive for COVID-19, according to the report. Twenty-six people have died.
Overall, 147 nursing homes across 27 states have at least one resident with COVID-19, according to data from the Centers for Disease Control and Prevention.
“The coronavirus outbreak at Life Care was an unprecedented situation for the state of Washington,” Washington Department of Social & Health Services Secretary Cheryl Strange said in a statement. “We have learned valuable lessons. We are applying these lessons daily in our efforts to prepare long term care facilities throughout the state for the potential of COVID-19.”
In a call Monday morning, CMS Administrator Seema Verma said the agency used its experiences and lessons in Kirkland to learn about the coronavirus and develop the new inspection approach.
“But beginning [Monday], for at least the next three weeks, we will work with the CDC to identify areas the virus is projected to strike next, and target our inspections accordingly. This will allow us to focus inspections on the most urgent situations, so we’re getting the information we need to ensure safety, while not getting in the way of patient care,” Verma said.
In other coronavirus-related news:
As of Monday, there were a total of 33,404 cases of COVID-19 in the United States and a total of 400 deaths, according to the Centers for Disease Control and Prevention.
CMS announced Monday night that 11 more states had been approved for Medicaid Section 1135 waivers, bringing the total to 13. The waivers allow states extra flexibility in dealing with COVID-19 complications.
Illinois Gov. J.B. Pritzker asked retired healthcare workers to “come back and join the fight against COVID-19” over the weekend. The state’s cases reached 1,285 as of Monday, along with 12 deaths.
The Pioneer Network has released several resources to help providers engage with residents and combat isolation during the pandemic.
