The Centers for Medicare and Medicaid Services (CMS) announced on March 13, 2020 enhanced penalties for infection control survey non-compliance amid the COVID-19 pandemic.[1] On June 1, 2020, CMS announced significant changes related to nursing home surveys. The new changes require states to complete 100 percent of their Focused Infection Control nursing home surveys by July 31, 2020.[2] If a state has not completed 100 percent of their infection control surveys by that date, it will be required to submit a corrective action plan (CAP) to CMS delineating its plan to complete the surveys within 30 days. After the 30-day CAP extension, if the surveys are still incomplete, the state’s CARES Act allocation for 2021 may be reduced by up to 10 percent.[3] Any additional extensions could result in further reductions up to 5 percent. The extra funds from the reductions will be redistributed to those states that completed their surveys by the July 31 deadline.

Nursing homes should take steps to ensure they are preventing the spread of infection and are cooperating with the surveyors. In addition to the strict infection control survey timeline, CMS is also requiring states to:

• Perform on-site surveys (within 30 days of the CMS guidance) of nursing homes with previous COVID-19 outbreaks, defined as:
  • Cumulative confirmed cases/bed capacity at 10 percent or greater; or
  • Cumulative confirmed plus suspected cases/bed capacity at 20 percent or greater; or
  • Ten or more deaths reported due to COVID-19.
• Perform on-site surveys (within three to five days of identification) of any nursing home with three or more new COVID-19 suspected and confirmed cases since the last National Healthcare Safety Network (NHSN) COVID-19 report, or one confirmed resident case in a facility that was previously COVID-19-free.
• Perform annual Focused Infection Control surveys of 20 percent of nursing homes based on data that identifies facility and community risks. States that fail to perform these survey activities timely and completely could forfeit up to 5 percent of their CARES Act Allocation, annually.

Nursing homes need to be cognizant of these stricter survey timelines and enforcement and stay up to date on the ever-changing COVID-19 guidance. For additional guidance on CMS surveys for nursing homes and infection control, please contact your Dinsmore Health Care attorney.