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Thu, Sept. 23

Column | Nursing home safety

Nursing homes have become ground zero in the coronavirus pandemic, with outbreaks causing high rates of illness and death among vulnerable residents living in close quarters. That’s why the Centers for Medicare and Medicaid Services (CMS) has taken aggressive actions over the last several months to protect nursing home residents.

We understand how terrifying these outbreaks are for nursing home residents and their families, and how essential it is for family members to know what is going on inside nursing homes. So, beginning in May, CMS required nursing homes that participate in Medicare and Medicaid to inform residents, their families and their representatives within 12 hours of when a confirmed COVID-19 case is reported, or when three or more residents or staffers develop respiratory symptoms within 72 hours of each other.

Residents, families and representatives must be given weekly updates or be told by the end of the next day each time a subsequent COVID-19 case is confirmed.

Nursing homes also must include information about actions they’re taking to prevent or reduce the risk of transmission, and inform residents and families about how those actions will change normal operations.

We also developed a system so the public can access data reported to the Centers for Disease Control and Prevention on the prevalence of COVID-19 at every CMS-certified nursing home in the country. This information is now available in a searchable database that allows people to look up individual nursing homes and see how many COVID-19 cases and deaths, among both residents and staffers, have been reported. This new system of reporting for nursing homes is unprecedented.

The data can be found at our Nursing Home Compare website. CMS will update the data weekly and take action against nursing homes that do not report required information. About 15,400 nursing homes nationwide are certified to accept people enrolled in Medicare or Medicaid.

The website features a Five-Star Quality Rating System to rate nursing homes. Early analysis of reported COVID-19 data shows that facilities with a one-star health inspection rating were more likely to have larger numbers of COVID-19 cases than facilities with a five-star rating.

In March, CMS and the states suspended standard inspections of nursing homes and began looking specifically for violations of infection control and prevention rules. We also provided an infection-control survey tool for nursing homes to do self-assessments to ensure they were taking necessary steps to protect their residents.

CMS is providing additional support and technical assistance to low-performing nursing homes through its Quality Improvement Organizations. QIOs are composed of health quality experts and clinicians with experience in helping healthcare providers improve care for people with Medicare. CMS directed QIOs to focus efforts on education and training at all nursing homes in the nation.

Finally, CMS recently provided state and local officials with recommendations on phased reopenings of nursing homes in their areas, including when to allow visitors.

Visits from family and friends are generally restricted at nursing homes now to help control and prevent the spread of the virus, except in compassionate care situations. We understand how hard it is to be separated from loved ones, especially elders, for so long.

But as nursing homes meet criteria, they may be in a position to allow visitors again. Our guidelines recommend visitation be allowed in Phase 3 with screening and additional precautions.

You can read more about the reopening guidelines at cms.gov/files/document/qso-20-30-nh.pdf-0. Be assured that CMS will use every tool at its disposal to protect the health and safety of America’s nursing home residents.

(Seema Verma is administrator of the federal Centers for Medicare and Medicaid Services.)

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