CMS Announces New COVID-19 Reporting Requirements for Nursing Homes

Regulation | April 20, 2020 | by Jodi Eyigor

CMS announces pending requirements for nursing home reporting of COVID-19. Nursing homes will be required to report directly to CDC.

CMS announced upcoming requirements for nursing home reporting of COVID-19 in a Quality, Safety & Oversight group memo on April 19. CMS reinforced existing requirements for reporting to state and local health departments on COVID-19 confirmed or suspected cases and clusters of respiratory illness, then announced that new requirements are forthcoming. Nursing homes will be required to additionally report information on cases and clusters directly to CDC through the National Health Safety Network (NHSN) system. CDC will publicly report this information, while using this data to support surveillance, monitor trends, and inform policy.

Additionally, CMS will require through rulemaking that nursing homes must continually update residents and their representatives of conditions within the nursing home related to confirmed COVID-19 cases or clusters of respiratory illness. Specifically, nursing homes will be required to update residents and families on a weekly basis in addition to providing notification within 12 hours of confirmed infections or clusters. Note that this includes cases or illness in both residents and staff. Nursing homes will also be required to inform residents and their representatives of actions implemented by the nursing home to prevent or reduce risk of transmission, including any changes to normal operations.

This forthcoming rulemaking will further direct that failure to timely report resident or staff incidences of infection could result in enforcement actions being taken by CMS against the nursing home.

What This Means for Providers

While LeadingAge continues to support nursing home reporting of COVID-19 cases, we are concerned with a few key points of this new announcement.

With the implementation of reporting through the NHSN system, nursing homes will be required to duplicate reporting to 2 government entities through 2 separate reporting processes. Providers should visit the CDC’s NHSN page to familiarize themselves with this system and process and work out any issues ahead of the impending requirement.

Additionally, LeadingAge is concerned about the potential for enforcement actions as stated in the announcement. At a time when nursing home providers are already managing an unprecedented crisis, the prospect of an enforcement action due to a new, complex and duplicative reporting system seems unnecessarily punitive. It is our hope that CMS will recommend the same review and approval prior to the implementation of remedies as was recommended for survey citations in Attachment A of the March 4 QSO memo.

In preparation for resident/resident representative reporting requirements, LeadingAge recommends reaching out to residents and representatives now to update them on the current status of COVID-19 in your nursing home, and to let them know they will soon be receiving regular updates if this is not already occurring. Coordinate internally to determine the most efficient and effective way your nursing home can keep residents and representatives up to date. Make sure that your chosen method accommodates the needs and preferences of your population, then develop a contingency plan to ensure that information and updates can be available even when things don’t go according to plan.

Also, review your infection control self-assessment (see CMS’s COVID-19 Focused Survey Tool, included in CMS memo QSO-20-20-ALL). Section 3 Infection Prevention and Control Program Standards, Policies, and Procedures, and Section 4 Infection Surveillance are particularly relevant to the expectations outlined in CMS’s latest announcement.

LeadingAge will monitor this developing situation and update members on rulemaking and other guidance as issued.