CMS Announcements: Resumption of Routine Inspections and Updated Guidance to States

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Late in the day Monday, August 17, 2020, CMS posted this Press Release.  The full title is: CMS Announces Resumption of Routine Inspections of All Provider and Supplies, Issues Updated Enforcement Guidance to States and Posts Toolkit to Assist Nursing Homes; subtitle: Guidance outlines recommendations to state agencies on Clinical Laboratory Improvement Amendments of survey activities.

Today, the Centers for Medicare & Medicaid Services (CMS) announced it will resume routine inspections of all Medicare and Medicaid certified providers and suppliers to improve the safety and quality of life of patients and residents. CMS had previously suspended certain routine inspections as part of its response to the coronavirus disease 2019 (COVID-19) pandemic to prioritize infection control and immediate jeopardy situations and to give health care providers and suppliers time needed to respond to the spread of COVID-19.

“At President Trump’s direction, CMS has worked closely with states to complete focused infection control surveys of virtually all nursing homes in the country in just a few months,” said CMS Administrator Seema Verma. “These surveys fortified healthcare facilities around the country to prepare for and implement actions to prevent transmission of the virus and provided indispensable insight into the situation on the ground. As CMS resumes some survey and enforcement activities that were previously put on hold, the health and safety of America’s patients will always be our top priority.”

In the guidance released today, CMS directed the resumption of onsite revisit surveys, non-immediate jeopardy complaint surveys and annual recertification surveys as soon as resources are available.  In addition, CMS is providing guidance on resolving enforcement cases that were previously on hold because of survey prioritization changes. The agency will also temporarily expand the desk review policy, when state surveyors ensure that facilities return back into compliance with Federal requirements without an onsite survey, to include all noncompliance reviews except for immediate jeopardy citations that have not been removed.

On July 31, CMS posted the latest results from the targeted nursing home infection-control inspections. Since March 4, CMS and its network of state-based inspectors have conducted more than 15,158 surveys, reflecting a 98.5 percent completion rate, with a total of 16,987 survey reports publicly available on Nursing Home Compare. CMS has imposed more than $15 million in civil money penalties (CMPs) to more than 3,400 nursing homes during the public health emergency for noncompliance with infection control requirements and the failure to report COVID-19 data.

CMS is also issuing updated guidance for the re-prioritization of routine state survey agency activities on Clinical Laboratory Improvement Amendments.  This updated guidance will provide flexibility and discretion to state survey agencies so that they can resume their survey activities based on the status of COVID-19 infections in their states.

CMS is also posting updates to the “Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes.” The toolkit details actions and best practices by organizations, state governments nationwide, and U.S. territories to assist nursing homes in meeting the needs of nursing home residents since the onset of the pandemic. The toolkit is updated on an ongoing basis to ensure it contains the most recent information available for providers and administrators of nursing homes to learn from an array of creative plans that state governments and other public health entities have put in place in a short period of time to contain the spread of the virus in nursing homes and meet the needs of America’s most vulnerable.

CMS is committed to protecting the beneficiaries it serves.  The agency develops and enforces federal safety standards across the healthcare system. CMS’s network of federal and state inspectors, as well as private accrediting organizations for some types of providers with programs approved by CMS, physically visit Medicare and Medicaid-participating health care providers to ensure compliance with these standards – including over 15,000 Medicare and Medicaid certified nursing homes.

QSO-20-35-ALL is a 9-page memorandum.

Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes – Version 7 is an update to previous version of the same toolkit.  This version is 160 pages.