DATE: June 1, 2020
TO: State Survey Agency Directors FROM: Director Quality, Safety & Oversight Group
SUBJECT: Revised COVID-19 Survey Activities, CARES Act Funding, Enhanced Enforcement for Infection Control deficiencies, and Quality Improvement Activities in Nursing Homes
CMS is committed to taking critical steps to protect vulnerable Americans to ensure America’s health care facilities are prepared to respond to the CoronavirusDisease2019(COVID-19) Public Health Emergency (PHE).
• CMS has implemented a new COVID-19 reporting requirement for nursing homes, and is partnering with CDC’s robust federal disease surveillance system to quickly identify problem areas and inform future infection control actions.
• Following the March 6, 2020 survey prioritization, CMS has relied on State Survey Agencies to perform Focused Infection Control surveys of nursing homes across the country. We are now initiating a performance-based funding requirement tied to the Coronavirus Aid, Relief and Economic Security (CARES) Act supplemental grants for State Survey Agencies. Further, we are providing guidance for the limited resumption of routine survey activities. CMS has revised the criteria requiring states to conduct focused infection control surveys due to the increased availability of resources for the testing of residents and staff and factors related to the quality of care.
• CMS is providing Frequently Asked Questions related to health, emergency preparedness and lifesafety code surveys
• CMS is also enhancing the penalties for noncompliance with infection control to provide greater accountability and consequence for failures to meet these basic requirements. This action follows the agency’s prior focus on equipping facilities with the tools they needed to ensure compliance, including 12 nursing home guidance documents, technical assistance webinars, weekly calls with nursing homes, and many other outreach efforts. The enhanced enforcement actions are more significant for nursing homes with a history of past infection control deficiencies, or that cause actual harm to residents or Immediate Jeopardy.
• Quality Improvement Organizations have been strategically refocused to assist nursing homes in combating COVID-19 through such efforts as education and training, creating action plans based on infection control problem areas and recommending steps to establish a strong infection control and surveillance program.