Insights & Resources

On April 24, 2020, the Centers for Medicare and Medicaid Services (“CMS”) issued a letter to State Agency Directors announcing that it will temporarily maintain the inspection rating for the Five Star Quality Rating System and that it will publish reported nursing home staffing levels to assist local governments in identifying nursing home needs. CMS also issued Frequently Asked Questions (“FAQs”) for nursing homes.

Nursing Home Compare Website and Five Star Quality Rating System:
Due to its prioritization and suspension of certain types of surveys (announced on March 23, 2020), CMS will temporarily hold the “inspection” domain constant to account for certain inspections that did not take place. On April 29, 2020, CMS will begin publishing the results of all health inspections that occur on or after March 4, 2020 – however, the results of those health inspections will not be used to calculate a nursing home’s health inspection star rating.
CMS had previously waived certain deadlines for nursing homes to submit Minimum Data Sets (“MDS”) and Payroll-Based Journal (“PBJ”). CMS emphasized that while the deadlines have been waived, these reports will impact the respective Five Star Quality domains as they relate to dates prior to the COVID-19 public health emergency, which began on January 31, 2020. CMS stated that while these waivers do not affect the April update, CMS will continue to monitor the circumstances going forward.

CMS to Publish Certain Nursing Home Staffing and Resident Information:
CMS announced that it has published certain PBJ information previously submitted by nursing homes for the fourth quarter of calendar year 2019. This information is generally used to calculate a nursing home’s staffing measures and staffing ratings for the Five Star Quality Rating System. CMS has published the average number of staff each nursing home has onsite each day (nursing staff and total staff) and the average census per day and total beds. The information is aggregated by state and nationally.
CMS believes publishing certain information will assist local, state and federal agencies in identifying facility needs and in developing their responses to preventing and controlling the spread of COVID-19, e.g., determining where to distribute personal protective equipment or direct testing.

FAQs for Nursing Homes: In addition to Guidance for Individuals Entering and Leaving Nursing Homes (March 13, 2020) and its COVID-19 Long Term Care Facility Guidance (April 2, 2020), CMS has published additional FAQs for nursing homes which address:

• Admission of individuals with confirmed or suspected COVID-19;
• Facility communication with resident families;
• Facilitation of resident communication with their families;
• Clarification on visitation restrictions and permitting visitation when there is a “compassionate care situation;”
• Clarification on what health care workers and/or non-essential health care personnel may enter a nursing home;
• Considerations for residents leaving the nursing home for appointments or under other circumstances;
• Cohorting (i.e., separating) residents based on known, unknown or suspected COVID-19 status within a facility or between facilities;
• Further clarification on waivers of certain federal requirements, including transfer and discharge requirements for nursing home residents; and
• Summary and additional guidance in connection with CMS’ prior guidance on survey and infection control self-assessments.

 
Should you have any questions regarding the above, please contact the Garfunkel Wild attorney with whom you regularly work, or contact us at info@garfunkelwild.com.