CMS Issues New QSO After White House Statement

Posted on December 1, 2022 by Kari Everson

The White House released a statement on Nov. 22 announcing a six-week campaign targeted to increase COVID-19 vaccinations nationwide. Within the message, the Biden-Harris administration has a section specifically focused on nursing homes and our existing requirement to educate residents and staff on COVID-19 vaccinations and offer vaccination.

Nursing home-specific information

The statement says explicitly, “CMS will make clear that nursing homes with low vaccination rates will be referred to state survey agencies for close scrutiny, and that facilities that do not comply with the requirement to offer and educate on the benefit of lifesaving COVID-19 vaccinations will face enforcement actions, including the need to submit corrective action plans to achieve compliance.”

It is unclear if this means initial vaccination rates or if it also refers to boosters as reported through NHSN. LeadingAge Minnesota is working to clarify this information. Further, our national affiliate is working with the US Department of Health and Human Services to inform guidance on vaccinations, including boosters, in our settings. When more information is available, LeadingAge Minnesota will provide information to members.

Other initiatives in the statement

The Biden-Harris administration included in the statement several other initiatives to promote vaccination. Examples include pop-up clinics for communities and organizations to increase access, additional funding for community-based organizations and health centers, creating opportunities for vaccinations to be more convenient, and continuing to raise awareness of the COVID vaccine. In addition, the White House statement indicated that the Center for Medicare and Medicaid Services would release updated guidance for nursing homes.

CMS released a new QSO on COVID-19 treatment

On Nov. 22, CMS released QSO-23-03-ALL to highlight the importance of providing timely therapeutics for those who tested positive for COVID-19. The memo reminds nursing homes to review and reinforce infection control protocols, educate residents and staff on COVID-19 vaccine risks and benefits, offer the vaccine, and report vaccinations to the National Healthcare Safety Network (NHSN). 

What’s new for nursing homes in the memo

CMS adds new direction to nursing homes in that they are to ensure residents receive appropriate treatment when they test positive for COVID-19. Treatment determinations must be made in consultation with the resident’s primary care provider and family. 

Operational considerations

• Review infection control protocols and determine if revisions and staff education are needed.
• Refresh education to residents and staff on COVID-19 vaccinations and the bivalent booster.
• Update the MD/NP/PA-C when a resident tests positive for COVID and provide information that CMS requires consideration of therapeutics per this memo. The prescriber will determine whether to order the treatment.
• Determine if it is appropriate for the organization to order antivirals ahead of time to keep stock on hand for immediate treatment. Work with your organization’s medical director to determine if this is appropriate for your community.
• Review NIH use of clinically appropriate therapeutics.
• Continue to report vaccinations to NHSN
• Document your interventions.

If you have additional questions, please contact Kari Everson.