The Centers for Medicare & Medicaid Services (CMS) announced new actions the agency is taking to limit the spread of the Novel Coronavirus 2019 (COVID-19), and released a series of memoranda designed to provide guidance to State Survey Agencies, Accrediting Organizations, and U.S. health care facilities, including nursing homes, on how they should respond to and contain the threat of the outbreak.
- Suspension of Survey Activities – The first memo indicates that, effective immediately, all non-emergency inspection activities are suspended so that inspectors can turn their focus to the most serious health and safety threats, including abuse and COVID-19 and other infectious disease control. In priority order, survey activity is temporarily limited to the following:
- All immediate jeopardy complaints (cases that represents a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death or harm) and allegations of abuse and neglect.
- Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses.
- Statutorily required recertification surveys (Nursing Home, Home Health, Hospice, and ICF/IID facilities).
- Any re-visits necessary to resolve current enforcement actions.
- Initial certifications.
- Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years.
- Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.
Attachment A on p. 3 of the memo, also includes protocols for the inspection process in situations where COVID-19 has been identified or is suspected, including required coordination with CMS regional offices and the Centers for Disease Control (CDC), as well as guidance related to inspector usage of adequate personal protective equipment.
- Guidance for Infection Control and Prevention Concerning Coronavirus Disease: FAQs and Considerations for Patient Triage, Placement and Hospital Discharge – The second memo provides guidance for hospitals and critical access hospitals (CAHs) on addressing the COVID-19 outbreak and minimizing transmission to other individuals. In FAQ form, the document addresses how facilities should be screening patients, staff, and visitors for their risk of infection based on symptoms or recent travel; whether to limit patient visitations; recommended infection prevention and control practices; protocols regarding the need for hospitalization, diagnostic testing, or therapeutic interventions; and discharge or transfer considerations, and more.
- Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes – The third memo provides a similar but added level of guidance for nursing home settings, where elderly and frail patients may be most at risk. For example, the memo addresses when a nursing home should consider transferring a resident with a suspected or confirmed case of COVID to the hospital.
Above all, CMS recommends that health facilities continue to monitor the CDC website for up to date information and resources. They also point to the following: