CMS Plans to Enforce New COVID-19 Reporting Requirements for Nursing Homes

Posted on April 21, 2020 by Jonathan Lips

The Centers for Medicare & Medicaid Services (CMS) announced in an April 19 Quality, Safety & Oversight memo (QSO-2026-NH) that nursing homes will soon be subject to two new reporting requirements – submitting communicable disease data to the Centers for Disease Control and Prevention (CDC) and providing COVID-related notifications to residents and resident representatives.

This announcement applies specifically to nursing homes and does not extend to assisted living. Please note that these requirements are not yet in place. CMS has not released all the details, and it has not identified the effective date when this reporting must begin, but this is what we know today:

Data Reporting to CDC

• All nursing homes will report data directly to CDC about residents or staff with suspected or confirmed COVID-19, residents with severe respiratory infection resulting in hospitalization or death, or ≥ 3 residents or staff with new-onset respiratory symptoms within 72 hours of each other.
• These CDC reports will be in addition to, and will not replace, infectious disease reports nursing homes already submit to MDH. Unfortunately, this will result in duplication of effort.
• CMS and CDC will provide nursing homes with specific direction on standard formatting and frequency for reporting this information through the CDC’s National Health Safety Network (NHSN) system, which is a healthcare-associated infection tracking system widely used by hospitals and by some long-term care facilities.
• We do not know what specific data elements CDC will define or what data submission mechanism CDC will establish. Enrolling with NHSN has been a cumbersome process, historically, and we are hopeful CDC will develop a streamlined process.
• CDC may perform on-site infectious disease surveillance, testing of healthcare personnel and residents, or other related activities, and CMS will expect facilities to cooperate with these efforts.

Resident and Resident Representative Reporting

CMS will also require nursing homes to provide COVID-related information to residents and resident representatives. CMS will finalize specific requirements through an expedited rulemaking process, but they have not yet published that information, so there is a lot we don’t know. However, the CMS memo signals that nursing homes will be expected to do the following:

• Notify residents and representatives within 12 hours of the occurrence of a single confirmed infection of COVID-19, or the new-onset of respiratory symptoms among three or more residents or staff within 72 hours of each other.
• Provide updates weekly, or each subsequent time a confirmed infection of COVID-19 is identified and/or whenever new onset of respiratory symptoms occurs for three or more residents or staff within 72 hours.
• Include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the nursing home will be altered.

Next Steps

The LeadingAge national team is working to obtain additional information from CMS, and we will report those details as soon as we have them. 

As this LeadingAge media release emphasizes, we are hopeful the reporting burden will be minimized, and that additional data will further inspire federal officials to prioritize allocation of PPE and testing supplies aging services provider settings, where it is desperately needed. We and LeadingAge national are advocating strongly on your behalf and will share more news on our request to CMS this week. 

Please reach out by email if you have any questions about these new reporting expectations, and we will add them to a frequently-asked-questions resource for members.