In light of findings from the COVID-19 outbreak at a nursing home in Kirkland, Washington, the Centers for Medicare and Medicaid Services (CMS) has announced that it will suspend all routine facility inspections and surveys for a variety of facilities, including hospitals, nursing homes, hospices and home health agencies. The findings, jointly developed by CMS and the Centers for Disease Control and Prevention (CDC), emphasized the risks of deficiencies in infection control which could create an “immediate jeopardy” situation in the facilities.
CMS had previously announced its intention for surveys and inspectors to focus on infection control practices such as hand-washing. The new guidance goes a step farther. Effective March 23, 2020, all routine facility inspections (such as those conducted for recertification) are suspended and postponed, as well as non-Immediate Jeopardy revisits (typically the result of deficiencies found in a prior survey). However, complaint inspections, initial certification inspections and targeted infection control inspections, using new tools developed for this purpose, will continue. In addition, facilities are being asked to conduct a self-assessment based on a checklist provided by CDC and CMS. Penalties associated with surveys that did not have a finding of immediate jeopardy are also been suspended.
Providers and facility operators should not interpret this as a license for non-compliance. CMS’ guidance has made clear that they will regularly be in facilities, as in the present environment, residents and their families can be expected to be more sensitive about complaints, particularly as it relates to infection control. Those engaging or preparing to engage in transactions for changes of ownership should anticipate delays related to inspections needed to close such transactions or transfer licenses/enrollment, and should be aware of penalties and other sanctions. As an effort to both maintain and demonstrate compliance, facilities should complete the recommended self-assessment and make it a priority for the facility’s governing body and relevant committees. Any documentation of non-compliance, plans of correction, and remediation activities should be maintained and become a regular fixture at governing body, medical staff and other quality-focused meetings.
CMS’ guidance document, along with the self-assessment tool, can be found at https://www.cms.gov/files/document/qso-20-20-all.pdf.
