Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
On Monday, May 11, 2020, Seema Verma – Administrator for the Centers for Medicare and Medicaid Services (CMS) – issued this letter to nursing homes across the country:
Dear Nursing Home Facility Management and Staff:
On behalf of the Centers for Medicare & Medicaid Services (CMS), thank you for your unwavering dedication and commitment to keeping residents safe and for continuing to compassionately care for those who rely on you during this unprecedented time. This pandemic poses unique challenges to our health care system unlike any other crisis in the modern era, and you are on the front line helping us protect an especially vulnerable population.
We share the same goal — keeping nursing home residents safe and healthy. CMS is accomplishing that goal through our regulatory and oversight work. Under President Trump’s leadership, we are leveraging CMS’ regulatory authority to facilitate your residents’ care and ensure that you have the guidance you need to prevent the spread of COVID-19 in your facilities.
It’s important that you, as a frontline care provider, have all the guidance at your disposal, and that you know what the Trump Administration is doing to ensure safety and quality in nursing homes. In early February, we reissued our longstanding infection control guidelines to help the system prepare for the virus’ spread into the U.S. Since that time, we have worked closely with our colleagues at the Centers for Disease Control and Prevention (CDC), forming a Nursing Home Task Force, to combine expertise and develop practical solutions to assist in monitoring and addressing the spread of COVID-19 within long term care facilities.
That coordination with CDC has been fruitful as we’ve begun to understand just how easily the virus is transmitted in nursing homes. We have advised nursing homes to temporarily restrict visitors. We understand the difficulty this must have posed for residents and their families and we truly appreciate your support in helping them understand why this action was necessary. We also streamlined our survey process to focus on infection control, and are deploying the Quality Improvement Organizations, as well as our regionally-based team of Medical Officers, to provide technical assistance to facilities. We temporarily suspended our long-term care facility professional practice rules, allowing nurse practitioners to perform some exams in place of a physician inside of nursing homes. We have led a historic expansion of telehealth services to keep nursing homes’ professionals that practice in additional settings safe from infection, which prevents potential spread to residents within the facility. Additionally, to increase access to services, we have waived the requirement for physicians and non-physician practitioners to perform in-person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options. We have also offered the entire health care system unprecedented flexibility to tailor the COVID-19 response to each individual community, through blanket waivers of our regulations. Critically, we issued recommendations to state and local leaders, suggesting that they work with nursing homes in their communities to identify needs for testing, personal protective equipment (PPE), and alternative care sites that could allow for cohorting ill and well residents to reduce the spread of infection. If your facility needs PPE or testing, contact your state health department immediately.
Finally, you may have heard our recent announcement that we are enhancing our existing reporting requirements for infectious disease by requiring nursing homes to report COVID-19 cases directly to CDC on a weekly basis. We also issued a new requirement for facilities to notify residents and their families and representatives to keep them up to date on the conditions inside the facility, such as when new cases of COVID-19 occur. These new requirements are absolutely critical to improve our nation’s COVID-19 surveillance so we can keep facilities safe and reopen America.
The best thing you can do today to keep your residents safe is to ensure you’re implementing essential infection control practices as outlined in our guidance: wash your hands properly; separate ill residents from well residents; learn how to correctly use PPE; stay home if you don’t feel well.
At this unprecedented time in our history, a significant responsibility has been placed on our shoulders: the responsibility to keep the most vulnerable Americans safe. By employing longstanding principles of infection control and prevention, closely coordinating on the local and state level, and showing patience and kindness to others, we can beat the virus, reopen America, and keep nursing home residents safe and healthy.
Administrator Verma’s letter is also found here. In a Regional Office announcement received just a few minutes ago today (May 12th), “Administrator Verma shared her gratitude for the unwavering dedication and commitment of nursing home management and staff in keeping residents safe and for continuing to compassionately care for those who rely on them during this unprecedented time. The letter also provides links to previously shared infection control resources.”