On August 25, 2020, CMS announced two new changes pertaining to nursing homes during the COVID-19 public health emergency. First, CMS published an interim final rule with comment period (IFC), which requires nursing home facilities to test all residents and staff for COVID-19 and report patient-specific results to HHS. Second, CMS implemented a national nursing home training program for frontline nursing home staff and nursing home management.

New Testing and Reporting Requirements for Nursing Homes

The IFC, titled “Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency,” requires nursing homes to test residents and staff, including individuals providing services under arrangement and volunteers, for COVID-19 based on parameters set forth by the Secretary of HHS. These parameters include, but are not limited to:

• Testing frequency;
• The identification of certain individuals diagnosed with COVID-19 in the facility;
• The identification of certain individuals with symptoms consistent with COVID-19 or with known or suspected exposure to COVID-19;
• The criteria for conducting testing of asymptomatic individuals, such as the positivity rate of COVID-19 in a county;
• The response time for test results; and
• Other factors specified by the Secretary that help identify and prevent the transmission

of COVID-19.

These parameters are set forth at new 42 C.F.R. § 483.80(h). Facilities that do not comply with this testing requirement will be cited for non-compliance and may face enforcement sanctions, such as civil monetary penalties in excess of $400 per day or over $8,000 for an instance of non-compliance.

The IFC also requires all laboratories and other facilities conducting testing for COVID-19 (including nursing homes) to report COVID-19 test results daily to the HHS Secretary. Non-compliance will result in a civil monetary penalty in the amount of $1,000 a day for the first day and $500 for each subsequent day. Labs will have a one-time, three-week grace period to begin reporting the required test data. On August 26, 2020, CMS issued additional guidance, outlining the steps that nursing homes must take under the new testing and reporting requirements.

The IFC is available here, and the CMS nursing home guidance is available here.

National Nursing Home Training Program

CMS’s Targeted COVID-19 Training for Frontline Nursing Home Staff and Management incorporates recent lessons learned from nursing homes, and teaches frontline staff best practices they can implement to address issues related to COVID-19. The training includes five modules designed for frontline clinical staff, which include:

• Module 1: Hand Hygiene and PPE
• Module 2: Screening and Surveillance
• Module 3: Cleaning the Nursing Home
• Module 4: Cohorting
• Module 5: Caring for Residents with Dementia in a Pandemic

The training also includes ten modules designed for nursing home management, which include:

• Module 1: Hand Hygiene and PPE
• Module 2: Screening and Surveillance
• Module 3: Cleaning the Nursing Home
• Module 4: Cohorting
• Module 5: Caring for Residents with Dementia in a Pandemic
• Module 6: Basic Infection Control
• Module 7: Emergency Preparedness and Surge Capacity
• Module 8: Addressing Emotional Health of Residents and Staff
• Module 9: Telehealth for Nursing Homes
• Module 10: Getting Your Vaccine Delivery System Ready

In addition to these training modules, CMS and CDC also have subject matter experts available on bi-weekly webinars from August 27, 2020, through January 7, 2021, from 4:00–5:00 P.M. ET, to answer questions.

The CMS announcement is available here, and the training is available here.