On April 19, 2020, the Director and the Quality, Safety and Oversight Group at CMS released a memo (Ref: QSO-20-26-NH) regarding upcoming requirements for notification of confirmed COVID-19 (or COVID-19 persons under investigation) among residents and staff in nursing homes. The information is a “heads up” as the final requirements have not been made public to date. In fairness, reading the memo, it makes you wonder if some providers are not being transparent with their residents, staff and family members. The language is quite concise and may change prior to the final requirements being posted however there isn’t anything here that should cause angst if we are all doing the right things for the right reasons.
I try to put myself in the shoes of our residents and families. We have restricted their visitation rights, ask them to wave through windows or talk on facetime but what about the “touch”. Most of our seniors grew up in a society of hugging, touching and being close but now the only time they see someone is when they are providing care. Then staff members come in with space suits on, masks and goggles and honestly can’t wait to get out of the room!
So think about it:
- First, take a minute to examine how things are being done in your center and you may find room for improvement.
- Second, “walk in their shoes”, determine if what you are currently doing is how you would want things done for you.
- And lastly, read the memo in its entirety and decide for yourself, isn’t this something we would want if we had a loved one in a nursing home right now?
Thank you and continue to do all the wonderful things you do for your residents, families, and staff. There is a light at the end of the tunnel and it isn’t an oncoming train! Be well, stay safe!
Memorandum Summary
CMS is committed to taking critical steps to ensure America’s health care facilities are prepared to respond to the 2019 Novel Coronavirus (COVID-19) Public Health Emergency (PHE). In addition to reporting to the CDC, CMS will also be requiring that facilities notify its residents and their representatives to keep them informed of the conditions inside the facility. This is separate from the reporting required to CDC in that this information will be shared by the nursing home directly with residents and their representatives.
At a minimum, once these requirements are in place, nursing homes must inform residents and their representatives 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.
Also, updates to residents and their representatives must be provided weekly, 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 occur within 72 hours.
Facilities will include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the nursing home will be altered. This information must be reported in accordance with existing privacy regulations and statutes.
Failure to report resident or staff incidences of communicable disease or infection, including confirmed COVID-19 cases (or Persons Under Investigation for COVID-19), or provide timely notification to residents and their representatives of these incidences, as required, could result in an enforcement action against the nursing home by CMS.
Finally, to ensure access by appropriate public health entities at the Federal, State or Local level, nursing homes are reminded of the requirements at 42 CFR 483.10(f)(4)(i)(A) and (B) which mandates immediate access to any residents by any representative of the Secretary or State. The purpose of these visits will be for CDC 9or its agents) to perform on-site infectious disease surveillance, testing of healthcare personnel and residents or other related activities as permitted under law.