CMS, CDC and QIOs Proactively Calling Nursing Homes

Posted on November 25, 2020 by Jonathan Lips

Minnesota nursing homes may be receiving calls with questions and offers of assistance from CMS, CDC, or Superior Health, the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Minnesota. The LeadingAge national team recently passed along this information from CMS about non-regulatory outreach currently underway:

General Inquiries: Each nursing home that has at least one positive diagnosis of COVID (and possibly those that have reported PPE or testing shortages) will receive a phone call from CMS, CDC, or a QIO and be given a 7-8 question assessment, then triaged for help. The questions might cover: PPE, cohorting, percentage of staff who completed the CMS/CDC training, frequency of testing, how the outbreak occurred, availability and supply of tests. Those needing the most help will be “triaged to resources” through state departments of health.

Testing Inquiries:  As CMS reviews NHSN data, it is monitoring for whether facilities report if they are testing when they also report COVID-19 cases. It also cross-references the positivity rates to see if facilities are reporting they are testing in yellow or red counties. Individuals from the CMS Office Program Operations and Local Engagement (OPOLE) and QIOs will be calling nursing homes to ask them why they may be in a yellow or red county yet reported no staff testing. Or, if they reported cases, yet reported no outbreak testing. These calls are primarily aimed at understanding why the facility reported no testing while the data shows they should have reported testing. They are not calling from a survey perspective—they are intended to be helpful. Calls already conducted have identified reporting issues, or that a facility was using the state’s positivity rate instead of CMS, or testing supply issues, or that some providers weren’t doing it without realizing they should. The intent is to identify the issues and help alert facilities.

We wanted to pass along this information to members, in case you receive a call and wonder about its purpose or legitimacy.