"Nursing Homes Need Help, We're Sending Help" Seema Verma Tells Katie Sloan

Members | August 25, 2020 | by Ruth Katz

Katie Sloan met with CMS Administrator Seema Verma to discuss questions and concerns.

Katie Sloan met with Seema Verma today (August 25) to discuss questions and concerns Katie had raised about HHS Nursing Home Strike Teams a week earlier in a letter to the Administrator. In addition to discussing the questions raised in the letter, the call covered other CMS nursing home-related activities. Matt Hittle, Senior Advisor to Seema Verma, Dr. Lee Fleisher, CMS Chief Medical Officer, and Ruth Katz joined the call. CMS shared a lot of helpful information on the call and LeadingAge was able to outline ongoing concerns and questions.

After thanking Administrator Verma for CMS’s help to date, Katie noted that LeadingAge appreciates that Strike Teams work in a collaborative, not punitive, manner to support providers. The Administrator agreed that nursing homes appreciate this kind of help, particularly as the number of cases in nursing homes increases.

Katie asked for more details about what the Strike Teams are finding and whether there will be additional webinars with more complex reporting, beyond the basics of handwashing and proper use of PPE. Administrator Verma answered that a lot of what the Strike Team experts learned was folded into the training released early this morning by CMS. She added that any or all of the 10 modules could be used by any other types of providers who want to use them and she hoped providers across the continuum would find them helpful.

Administrator Verma reported on a few items that were subsequently released by CMS later in the day. She said that $2.5 billion of the $5 billion in Provider Relief Funds for SNFs that were announced in July would be paid out later this week.

Regarding PPE shortages, Seema Verma was clear about how HHS and FEMA are handling them. This too was reinforced on the call later in the day. She described how FEMA staff review the NHSN data submitted to CDC; 90% of nursing homes report in that data that they have enough PPE to last for at least the next week. The data on the 10% that report not having a week’s worth of PPE trigger a response from FEMA, which in turn reaches out to them and provides the needed supplies.

Katie explicitly asked CMS to require testing of surveyors. The response was that surveyors have full PPE, comparable to what staff have. We asked how she would advise discussing this with providers and families who don’t understand why hospital workers aren’t tested and why family members, if they have full PPE cannot also enter nursing homes.

The Administrator cited a study by CDC that did not find transmission of COVID from hospital staff to patients. We will follow up with CMS on this. Transitioning to visitation, she said that she understands the challenges nursing homes, residents, and family members face and said CMS would be putting out additional visitation guidance soon that would expedite reunification of residents and family members.

Dr. Fleisher clarified his remarks on the webinar. He said even in hospitals, there are constant reminders to adjust your PPE, so reviewing this information with nursing home staff is a good idea. He apologized that he did not fully grasp all the details of nursing home regulations, being new on the job, and said infection preventionist requirements in RoPs have not changed. Finally, he said that CDC guidance on when to return to work is the operative CMS guidance as well (not a negative test).

As to whether strike teams will continue in nursing homes, Administrator Verma confirmed what we had heard from other parts of HHS, that they will, saying “nursing homes need help, we’re sending help.” She said there were no plans to dismantle something that’s working.

Finally, when Katie asked if the interim final rule would be out soon, Seema Verma said it would be out today – which is exactly what happened.