The Centers for Medicare and Medicaid Services (CMS) has collaborated with the Centers for Disease Control (CDC) to provide additional guidance related to the notification of suspected and/or confirmed COVID-19 cases among nursing home residents and staff. The updated guidance will impact communicable disease reporting requirements and the notification process to a facility’s residents and their representatives. CMS anticipates the implementation of new rule making and requirements concerning this guidance in the near future.
Currently, nursing homes are required to create and maintain an infection prevention and control program. This typically includes a surveillance system to identify possible communicable diseases or infections before they can spread to other persons in the facility; and when and where possible incidents of communicable disease or infections should be reported.
Notification to Officials
Current CMS regulations and CDC guidance require nursing homes to notify their State or Local health department of, “residents or staff with suspected or confirmed COVID-19, residents with severe respiratory infection resulting in hospitalization or death, or ≥ 3 residents or staff with new-onset respiratory symptoms within 72 hours of each other.” Nursing homes may also opt to report this information through the CDC’s National Health Safety Network (NHSN) system. However, this data is not currently collected by CDC, CMS or FEMA.
Under the new guidance, CMS and CDC will soon provide nursing homes with specific direction for reporting this information to the NHSN system. The information obtained will be used to support surveillance of COVID-19 locally and nationally, monitor infection rates and trends, and inform public health policies and actions. This information may be retained and publicly reported in accordance with applicable federal and state public records laws.
Notification to Residents and Their Representatives
The CMS and CDC are also expected to provide new requirements for nursing homes to inform their residents and their representatives of suspected or confirmed cases of COVID-19 within their facilities. At a minimum, the following communication requirements will be mandated:
- Residents and their representatives must be informed within 12 hours of the occurrence of a single confirmed infection of COVID-19, or three or more residents or staff with new-onset of respiratory symptoms that occur within 72 hours.
- A weekly COVID-19 update must be provided to residents and their representatives, or each subsequent time a confirmed infection of COVID-19 is identified and/or whenever three or more residents or staff with new onset of respiratory symptoms occurs within 72 hours.
- Each update must report any actions implemented by the facility to prevent or reduce the risk of transmission, including any alteration in normal operations.
- Each update must be in accordance with existing federal and state privacy regulations and statutes
- Failure to report resident or staff incidences of communicable disease or infection, including suspected or confirmed COVID-19 cases, or provide the required timely notifications to residents and their representatives of these incidences could result in an enforcement action against the nursing home by CMS.
Public Health Monitoring Requirements
Finally, CMS is reminding nursing homes of requirements pursuant to 42 CFR 483.10(f) (4)(i)(A) and (B), mandating the immediate access to any resident by any representative of the Secretary or State in order for the, “CDC (or its agents) to perform on-site infectious disease surveillance, testing of healthcare personnel and residents, or other related activities, as permitted under law.”
The full CDC guidance to prepare nursing homes for COVID-19 can be found here.
For more information
If you have questions or concerns about compliance with guidelines for health care professionals or facilities related to COVID-19, please contact Sheri L. Pizzi or Greg Vanden-Eykel by email, or by calling 617-654-8200.
Barton Gilman has established a highly-regarded reputation for successfully defending nursing homes and long-term facilities against claims of wrongful death, abuse, neglect, or mistreatment. Our attorneys are thoroughly versed on the complex web of state and federal rules, regulations and pending legislation that impact our clients in this highly regulated industry. For more information, please click here.