The Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health payment rule on November 1. This year’s rule included nursing home provisions related to reporting through the National Healthcare Safety Network (NHSN). Provisions were mostly finalized as proposed and will take effect on January 1, 2025.

While LeadingAge had advocated termination of all reporting requirements, we note that finalized requirements will be an improvement over current reporting obligations.

These requirements, initially implemented in May 2020 through an interim final rule and extended in the CY2022 Home Health rule, would have expired on December 31, 2024 without further action from CMS. With the CY2025 Home Health rule, NHSN reporting has been made a permanent provision of the Requirements of Participation. Additionally, reporting has been expanded to include data on flu and respiratory syncytial virus (RSV) in addition to currently required COVID data.

LeadingAge notes, however, that reporting requirements have been streamlined. Beginning January 1, nursing homes will report weekly through NHSN on the following data elements:

• Facility census
• Resident vaccination status for COVID, flu, and RSV
• Confirmed resident cases of COVID, flu, and RSV, reported as overall numbers and delineated by vaccination status
• Hospitalized residents with confirmed cases of COVID, flu, and RSV, reported as overall numbers and delineated by vaccination status.

As of January 1, nursing homes will no longer report COVID impact on healthcare personnel. Nursing homes will, however, continue to report on flu and COVID vaccination status of healthcare personnel per requirements of the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). In the rule, CMS references this reporting, stating that nursing homes report healthcare personnel COVID vaccination status quarterly. While the data is transmitted to the SNF QRP quarterly, the data is reported weekly by nursing homes at this time as part of current requirements. LeadingAge is working to confirm with CMS what frequency of healthcare personnel COVID vaccination reporting will be required as of January 1.

Additionally, the CY2025 Home Health rule finalized provisions to allow the Health & Human Services (HHS) Secretary to adjust reporting in the future event of a public health emergency. Adjustments could include modifying the respiratory illnesses on which nursing homes are reporting data, modifying or increasing the data elements, or increasing the frequency of reporting, all without traditional notice and comment rulemaking processes. CMS did not finalize provisions that would allow these same flexibilities for the Secretary in the event that a future public health emergency was likely to occur. In other words, a public health emergency must be declared before the Secretary may exercise these powers without notice and comment rulemaking.

LeadingAge will continue to work with CMS to determine future requirements for healthcare personnel COVID vaccination reporting, and to advocate for resolution of the outstanding issue of duplicative resident COVID and flu vaccination reporting.