On Friday, May 1, 2020, The Centers for Medicare & Medicaid Services (CMS) issued an Interim Final rule, “Medicare and Medicaid Programs, Basic Health Program, and Exchanges; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program” that covers many topics. Of note due to the current COVID-19 pandemic is the requirement for nursing facilities to report resident and staff COVID-19 infections, potential COVID-19 infections and COVID-19-related deaths. This reporting requirement was outlined in a CMS QSO Memo in mid-April.
CMS notes in the IFC that the Agency believes these reporting requirements are necessary to ensure that it can monitor whether individual facilities are appropriately tracking, responding to, and mitigating the spread and impact of COVID-19 in their buildings.
Nursing Home Regulatory Reporting Requirement
CMS states that in order to support increased COVID-19 surveillance efforts, the Interim Final Rule with comment period (IFC) outlines the revised reporting requirements for nursing homes to report confirmed or suspected cases of COVID-19. This information will provide trending data related to infection rates and allow for the development of public health policies. The requirements include electronic reporting in a standardized format that includes:
- Suspected and confirmed cases of COVID-19 in the nursing home among both residents and staff
- This information will include residents that were previously treated for COVID-19
- Total deaths and COVID-19 deaths among both residents and staff
- Count of PPE and hand hygiene supplies available in the facility
- Ventilator capacity and supplies available in the facility
- Resident beds and census
- Access to COVID-19 testing while a resident is in the facility
- Staffing shortages
All of this information is being captured through the CDC National Health Safety Network (NHSN) Long-Term Care Facility COVID-19 Module. This information must be provided no less than weekly to the CDC’s NHSN. The Rule also states that this information will be provided to CMS and reported publicly.
It is also important to note that this new reporting requirement does not replace regulatory requirements for reporting possible incidents of communicable diseases and infections, including those for compliance with state and local COVID-19 reporting requirements. This is an additional set of reporting.
LTCF COVID-19 Module
More information about the reporting requirements, forms to fill out and training are available on the CDC website under the LTCF COVID-19 Module.
- Training is being provided for nursing homes. The slides for the training can be accessed here. Training dates and links are also available on the site.
- There are four pathways included in the module, and each comes with a set of data collection forms and instructions:
- Resident Impact and Facility Capacity Pathway Form and Table of Instructions
- Staff and Personnel Impact Pathway Form and Table of Instructions
- Supplies and Personal Protective Equipment Pathway Form and Table of Instructions
- Ventilator Capacity and Supplies Pathway Form and Table of Instructions
- There are CSV files available for facilities to input their information in the standardized format at the bottom of the CDC webpage as well.
Reporting Requirement for Residents, Representatives and Families
In addition to the reporting requirements outlined above, the IFC outlines a new nursing home reporting requirement to keep residents, resident representatives and their families informed about COVID-19. Specifically:
- Nursing homes must inform their residents/reps and families by 5pm on the next calendar day following the occurrence of either:
- A single confirmed case of COVID-19 or
- Three of more residents or staff with new-onset of respiratory symptoms that occur within 72 hours of each other.
- Nursing homes must also provide cumulative updates to residents/reps and families at least weekly by 5pm the next calendar day following the subsequent occurrence of either:
- Each time a confirmed COVID-19 infection is identified or
- Whenever three or more residents or staff with new onset of respiratory symptoms occur within 72 hours of each other
- Information on mitigating actions being implemented to reduce the risk of COVID-19 transmission must be included in the updates, including if the facility is operating in a manner other than normal, such as by restricting visitation, community dining and group activities.
- Information may not include Personally Identifiable Information (PHI) and must be compliant with existing privacy regulations.
- Facilities have flexibility in how this information is provided, and the IFC states that it is not requiring individual telephone calls to satisfy this reporting requirement.
Read the full interim rule in the Federal Register (scheduled publication date is 5/8/2020). We’ll be sharing additional updates from this rule on the CMSCG Blog shortly.
