On March 4, 2020, the Centers for Medicare & Medicaid Services (CMS) issued three Quality, Safety & Oversight Memoranda, all concerning the Coronavirus. According to these documents, effective immediately, the government will begin to focus its inspections exclusively on issues related to infection control and other serious health and safety threats. According to CMS Administrator Seema Verma, the memoranda should be seen as a “call to action across the healthcare system.” The goal of the guidance given in the memoranda is to continue to keep Americans safe and prevent the spread of the Coronavirus.
The first memorandum resets the focus of governmental surveys. The order of priority for government surveys will now be:
- Immediate jeopardy/abuse and neglect allegations;
- Infection control complaints;
- Statutorily-required surveys (Nursing Home, Home Health, Hospice, and ICF/IID Facilities);
- Revisits related to current enforcement actions;
- Initial certifications;
- Facilities with a history of infection control deficiencies over the last three years;
- Facilities with a history of infection control at levels below “immediate jeopardy.”
This first memorandum also includes inspection protocols for situations in which the Coronavirus is identified or suspected. These include guidance concerning adequate personal protective equipment for inspectors.
The second memorandum focuses on hospitals. The memo provides guidance on visitor and patient screening as well as monitoring or restricting facility staff from working in the event of exposure. The memo suggests questions about recent travel to countries with known cases of Coronavirus infection and the severity of infection, in order to differentiate between the need for hospitalization and self-isolation. The memo also covers patient placement and evaluation, along with precautions covering diagnostic and therapeutic interventions, discharge and visitation.
The third memorandum covers nursing homes. This document provides guidance similar to that given to hospitals. This includes including guidance for monitoring and restricting staff, and managing transfers and admissions of patients with suspected or confirmed Coronavirus infection. Hospital transfers are also addressed in the memo.
CMS also announced that it was sending an “infection prevention specialist” to the Center for Disease Control and Prevention in Atlanta. This individual will help provide real-time guidance as more information about the virus, and its spread, becomes available.
According to CMS, these actions are designed to protect the public by ensuring that health care facilities: (i) have up-to-date information about the virus; (ii) are able to adequately respond to Coronavirus concerns; and (iii) are held accountable for maintaining effective infection control standards. CMS will continue to update the standards as circumstances require, with the hope that the threat from the virus will begin to diminish.