CMS issues survey memorandum related to infection control and enforcement actions

The Centers for Medicare & Medicaid Services (CMS) issued a memorandum on June 1, 2020 addressing survey activities, including the prioritized and focused infection control surveys. The memorandum also addressed enhanced enforcement actions related to surveys, The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) funding and Quality Improvement Activities in nursing homes. The memorandum reference is QSO-20-31-ALL. 

In March 2020, CMS issued a memorandum suspending standard surveys and several other levels of state survey activities while prioritizing the infection control surveys as a result of the coronavirus pandemic. This memorandum provides guidance for limited resumption of routine survey activities and initiates a performance-based funding requirement that is linked to the CARES Act supplement grants for state survey agencies.

Information in the memorandum reports that CMS is enhancing the penalties for noncompliance with infection control to “provide greater accountability and consequence for failures to meet these basic requirements.” The basic requirements include the new COVID-19 reporting requirements for nursing homes to the Center for Disease Control (CDC) National Healthcare Safety Network (NHSN). The NHSN is a federal disease surveillance system to assist with identification of problem areas to increase actionable infection control items.

The enhanced enforcement actions follow what CMS describes as their focus on equipping nursing homes “with the tools they needed to ensure compliance, including 12 nursing home guidance documents, technical assistance webinars, weekly calls with nursing homes and many other outreach efforts.” Nursing homes who have a history of past infection control deficiencies or where actual harm to residents or immediate jeopardy level deficiencies have been cited will experience more significant enhanced enforcement actions.

The Quality Improvement Organizations (QIOs) have been required to strategically refocus their activities to assist nursing homes related to the COVID-19 pandemic activities. These activities include education and training, action plans centered on infection control areas of concern and recommendations related to implementing effective infection control and surveillance programs.

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