Nursing homes face CMS scrutiny in light of newly released COVID-19 death totals

June 04, 2020

Nursing homes reported that nearly 26,000 residents have died from COVID-19, while 60,000 were infected as of May 24, according to data released this week from CMS. The analysis did not capture all deaths and cases, as only 80% of Medicare and Medicaid facilities had submitted their data on time.

Nursing homes with one-star rankings were more likely to see higher COVID-19 case counts than facilities with five stars, CMS found in its review of its quality ratings.

CMS plans to distribute $80 million to states to boost infection control surveys, and is requiring all facilities to have inspection surveys by July 31. Those states that do not comply by July will have a 30-day period to do so or are in danger of losing percentages of their CARES Act FY 2021 allocations.

“We’re ratcheting up penalties with non-compliance to infection control,” CMS administrator Seema Verma told reporters this week, according to McKnight’s Long-Term Care News. “The fines are more significant for nursing homes with a history of past infection control deficiencies.”

HHS Office of the Inspector General also announced it will perform an audit of nursing homes to make sure effective infection prevention and control programs are in place.

HRI impact analysis

The industry has argued that more resources are needed to combat the spread of infection. LeadingAge, the Visiting Nurse Associations of America and ElevatingHOME have pressed Congress for full financial coverage of testing costs, not just the kits, as well as coverage for repeat testing, PPE and temporary staff replacement that would be needed in the case that a staff must quarantine.

In May, the White House issued a recommendation urging governors to ensure that all nursing home residents and staff be tested. However, the American Health Care Association told the Associated Press that to execute this recommendation it would involve testing 3 million people and cost nearly $440 million. Further, nursing homes are struggling to find the time and staff required to conduct adequate testing.

With a second wave of COVID-19 expected, providers may rethink care delivery models where it is possible, increasing virtual health, remote monitoring and home healthcare services to help limit interactions and protect their vulnerable populations.

Structural changes to their operations in terms of where COVID-19 patients are cared for, and how to isolate other residents, may also be considered to fortify plans before the potential fall wave is expected.

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Trine K. Tsouderos

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Crystal Yednak

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Erin McCallister

Senior Manager, Health Research Institute, PwC US

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