IPCWell - Infection Control Consultant & Expert - United States

CMS Nursing Home Surveys During a Pandemic:

An Open Letter Asking for Support Rather Than Fines

While the government has stated its commitment to safeguarding nursing home residents from the ongoing threat of Covid-19, they also have taken aggressive enforcement action against Medicare and Medicaid certified facilities that fail to implement proper infection control practices.

Starting in March, they surveyed over 15,000 nursing homes. The amount of deficiencies found during this time tripled the same rate in 2019.  These surveys resulted in $15 million dollars in CMPs, or Civil Money Penalties. Fines.

According to McKnights Long-term Care News, these citation and fine numbers came a day after CMS Administrator Seema Verma had assured providers on a conference call, “We are here to help you and support you. This isn’t a time of fines and being punitive. It is a time … to be problem solvers.” How does issuing a fine of over $20,000 “help” or “support” a facility?

Every day, staff in long-term care facilities are busting their butts keeping our loved ones safe. They are putting themselves at risk while we sit comfortably in our homes watching the latest Netflix series. During this pandemic, facilities have struggled to obtain PPE, find and fund COVID-19 tests, juggle the mental health of residents vs isolating them to their rooms, and spend countless hours reporting data to the county, state, and federal public health entities. It’s been a struggle to stay abreast of the current protocols that adhere to CMS’s constantly changing guidelines. From February to August, CMS issued 18 sets of COVID-19 guidance. Then they come into the facilities and expect absolute perfection in implementing this guidance.

The American Heath Care Association (AHCA) points to academic studies that show location of the facility (how much the virus is spreading in the surrounding community), availability of testing, and asymptomatic spread were greater determining factors for outbreaks rather than inadequate infection control policies. AHCA president Mark Parkinson states, ““Our focus should be on getting a handle on the amount of spread in the surrounding community and prioritizing nursing homes for ongoing resources.”

Unsustainable, blind monetary penalties take away precious resources at a critical time. Industry leaders across the board are asking for support and training to help navigate best infection control practices and stay in compliance while fighting this virus.

One nursing home in Michigan told me that CMS came in and handed them 53 pages of citations with no help. No training. No education. Is this what CMS calls help and support? Our long-term care facilities DESERVE better!

Giving a facility a list of guidelines is a single ingredient to a complex recipe for minimizing harm in our facilities. Each building faces a unique set of challenges. Support needs to come from people that are plugged in to long-term care, people that understand what these facilities are going through, and what the staff and residents are facing.

Let’s dispatch some “boots on the ground” teams who can take action in really giving our facilities a chance in their fight in keeping our loved ones and healthcare personnel safe!