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03/05/2020

White House Directs Survey Agencies to Support Nursing Homes in COVID-19 Prevention

White House Directs Survey Agencies
to Support Nursing Homes
in COVID-19 Prevention

Yesterday the White House announced changes to nursing home survey practices in response to the mounting threat of COVID-19, known as the coronavirus. The Trump Administration has expressed its desire for Centers for Medicaid and Medicare Services (CMS) surveyors to prioritize infection control in the wake of increasing numbers of Americans suffering from the disease.

The White House Coronavirus Task Force announced the change in focus at a press conference on Wednesday afternoon. Vice President Pence, acting on behalf of the task force, announced that:

“At the President’s direction, we’re going to focus exclusively on ensuring that those who are in nursing homes — people operating the nursing homes, like many of the CEOs that we met with today — are complying with the new standards to keep our elderly safe.”

According to the CMS memo:

“CMS is committed to taking critical steps to ensure America’s health care facilities and clinical laboratories are prepared to respond to the threat of the COVID-19 and other respiratory illness. Specifically, CMS is suspending non-emergency inspections across the country, allowing inspectors to turn their focus on the most serious health and safety threats like infectious diseases and abuse. This shift in approach will also allow inspectors to focus on addressing the spread of the coronavirus disease 2019 (COVID-19). CMS is issuing this memorandum to State Survey Agencies to provide important guidelines for the inspection process in situations in which a COVID-19 is suspected.”

The announcement references guidance being provided to state survey agencies to change their approach to surveying nursing homes, including: limiting standard and complaint surveys; focusing efforts on nursing facilities that have had previous citations related to infection control; and continuing to focus on immediate jeopardy complaints and allegations of abuse and neglect.

“We will be focusing all of our state agency resources that are involved in inspecting nursing homes and other healthcare facilities to focus on infection control practices,” stated Seema Verma, Administrator for CMS.  “Healthcare providers are going to play a very critical role in preventing the spread of the coronavirus, and CMS has a unique role in holding healthcare providers accountable for maintaining these essential health and safety standards.”

She went on to note other plans, including:

  • Issuing a call to action to hospitals, nursing homes, dialysis providers, and all healthcare facilities to review their infection control and emergency preparedness procedures;
  • Reissuing some guidance around infection control, transfers between nursing homes and hospitals, and encouraging and requiring providers to consult with local healthcare officials;
  • Issuing guidance around screening visitors and healthcare workers; and
  • Issuing guidance to state surveyors that provides information on the latest Centers for Disease Control and Prevention (CDC) protocols that they must follow when inspecting these facilities with suspected cases of respiratory illness, including coordinating with the CDC, CMS, and local healthcare officials. 

The response from LeadingAge (national) appeared to be cautiously optimistic, while additionally urging policymakers to address the needs of older adults living in other congregate and community-based settings.

“They (the CMS directives) appear to represent an opportunity for much-needed collaboration with surveyors to achieve our joint goals of infection containment and high-quality care,” stated Katie Smith Sloan, President & CEO of LeadingAge.

“We are pleased that CMS has directed these important resources to support nursing homes on the frontline of care,” said Kathryn Brod, President/CEO of LeadingAge Ohio. “While no cases of COVID-19 have yet been confirmed in Ohio, nursing homes care for those who are most at risk of being affected, and deserve the partnership and support that yesterday’s announcement implies.”

LeadingAge Ohio has already been in conversation with the Ohio Department of Health (ODH) regarding how this will be enacted in Ohio. We will share any relevant updates with our membership as they come to us.

This announcement comes on the heels of the deaths of five individuals at a Seattle, Washington nursing home, with the deaths being blamed on COVID-19. Governor Mike DeWine’s administration is taking steps to limit the spread of the disease to Ohio, including barring spectators from the attending the Arnold Classic Sports Festival, which regularly draws hundreds of thousands of visitors from over 80 countries.

LeadingAge Ohio recently shared a collection of information with members on coronavirus control and prevention, including speaking points for members with nursing facilities and home health and hospice members. The information (below) is available to all members and on LeadingAge Ohio’s homepage.

LeadingAge Ohio continues to monitor the situation, and will provide the latest updates directly to members as we receive them. We are aware that all providers are having issues placing orders for additional PPE supplies such as masks. We will continue to monitor and update our members on these shortages.

Members who are concerned about the impact of COVID-19 to their operations are encouraged to reach out to Patrick Schwartz, Director of Strategic Communications at pschwartz@leadingageohio.org for direction to staff and resources.

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.