Government Re-Prioritizes Nursing Home Inspections and Visits Due to Coronavirus

The coronavirus epidemic is pausing inspections conducted by State Survey Agencies (SSAs). The most recent Centers for Medicare & Medicaid Services (CMS) guidance related to nursing homes and coronavirus includes a pull-back of regular CMS inspections. The federal agency said it would only conduct revisits when Immediate Jeopardy (IJ) is cited.

CMS defines IJ as: “… a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death. These situations must be accurately identified by surveyors, thoroughly investigated, and resolved by the entity as quickly as possible. In addition, noncompliance cited at IJ is the most serious deficiency type, and carries the most serious sanctions for providers, suppliers, or laboratories (entities). An immediate jeopardy situation is one that is clearly identifiable due to the severity of its harm or likelihood for serious harm and the immediate need for it to be corrected to avoid further or future serious harm.”

If an active case of COVID-19 is found during an IJ complaint subject to availability of PPE and other state emergency responsibilities, surveyors have been asked to report the case and facility to their agency, the state health department, and the CMS Regional Office to decide on further action.

Understanding the Three-Week Prioritization Period

On March 20, CMS began a three-week period referred to as the prioritization period. During this time, CMS is prioritizing and only conducting the following surveys:

  • Complaint/facility-reported incident (FRI) surveys that are triaged as IJ.
  • Targeted Infection Control Surveys of providers identified through collaboration with the Centers for Disease Control and Prevention (CDC) and the HHS Assistant Secretary for Preparedness and Response (ASPR).
  • Initial certification “in order to increase the health capacity of the country.”
  • These surveys will only be conducted on site if surveyors have access to Personal Protective Equipment (PPE).

Standard surveys for nursing homes and revisits not associated with IJ will not be authorized. Surveyors and regional offices must adhere to the following guidelines:

  • State survey agencies should follow their normal process for triaging complaints and FRIs.
  • Non-IJ complaints should be entered into the CMS tracking system and not investigated.
  • IJ complaints should be surveyed following normal policies and procedures.

Nursing homes should notify their health department about residents with a severe respiratory infection or a cluster of respiratory illness, or suspicion of a coronavirus infection or outbreak.

Coronavirus Outbreaks Caused by Nursing Home Negligence

If a loved one has sustained a serious injury or infectious disease complication resulting from neglect or missed medical treatments provided by a nursing home, or the intentional understaffing of its workforce, we can help. Please reach out to Levin & Perconti, a Chicago-based law firm ready to provide you with a free nursing home abuse or provider negligence consultation at (312) 332-2872.

Also read: First Illinois Nursing Home to Report Coronavirus Outbreak is in DuPage County