CMS Doles Out $15M in Fines to Nursing Homes During COVID-19

CMS recently announced that more than 3,400 nursing homes were fined because of noncompliance with infection control requirements and failure to report COVID-19 data during the public health emergency.

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The nursing homes now face over $15 million in civil monetary penalties, according to the federal agency.

“The Trump Administration is taking aggressive enforcement action against Medicare and Medicaid certified nursing homes that fail to implement proper infection control practices,” CMS Administrator Seema Verma said in the announcement. 

“Now more than ever, nursing homes must be vigilant in adhering to federal guidelines related to infection control to prevent the spread of infectious disease, including COVID-19,” Administrator Verma stated. “We will continue to hold nursing homes accountable and work with state and local leaders to protect the vulnerable population residing in America’s nursing homes.”

The fines stemmed from heightened inspection protocols initiated in early March to allow inspectors to focus on compliance with infectious disease requirements and abuse, CMS said in the announcement.

Nearly all nursing homes in the US (99.2 percent) underwent one of the inspections, or surveys, for infection control compliance since March 4, 2020.

The surveys resulted in more than 180 “immediate jeopardy level findings” for infection control, which is triple the rate of infection control deficiencies found in 2019, CMS reported.

“Immediate Jeopardy represents a situation in which a nursing home’s noncompliance with CMS requirements of participation has caused or is likely to cause serious injury, serious harm, serious impairment, or death to a resident,” the federal agency stated in the announcement.

CMS doled out nearly $10 million in civil monetary penalties to nursing homes with immediate jeopardy infection control deficiencies. The average penalty was $55,000.

The federal agency also took enforcement action for the more than 3,300 deficiencies related to COVID-19 data reporting.

Early on in the pandemic, CMS partnered with the Centers for Disease Control and Prevention (CDC) to implement a nationwide COVID-19 reporting system. Medicare and Medicaid-certified nursing homes were required to report COVID-19 cases and deaths, among other information, to the CDC.

The majority of nursing homes complied with the new data reporting requirement during the public health emergency, with over 99 percent of facilities reporting COVID-19 data by August 3, 2020, CMS pointed out.

However, nursing homes that have not reported COVID-19 data or that have stopped reporting the information to the CDC now face over $5.5 million in civil monetary penalties, per recent CMS enforcement actions.

The enforcement actions are to “ensure nursing homes fulfill their responsibility to provide safe and effective care to their residents,” CMS stated.

Nursing homes have been and continue to be a hotbed for COVID-19 activity.

According to a recent report from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), COVID-19 cases in nursing homes are spiking again, with the facilities surpassing the peak level from May.

There were 9,715 confirmed cases of COVID-19 in US nursing homes by July 26, 2020. The level is higher than the previous high of 9,421 cases on May 31, 2020, and significantly higher than the low of 5,480 cases back in late June.

But high levels of COVID-19 activity in nursing homes is not a result of inadequate infection control, AHCA/NCAL maintain.

“Location of a nursing home, asymptomatic spread and availability of testing – not quality ratings, infection citations or staffing – were determining factors in COVID-19 outbreaks according to independent analyses by leading academic and health care experts,” the organization recently explained.

In particular, a study from Harvard University, with support from the National Institute on Aging and National Institutes of Health, found that COVID-19 outbreaks in nursing homes located in several major cities, including New York City, mirrored the rate of spread among the general population.

The findings were also consistent with AHCA/NCAL’s own research, which analyzed recent CMS data on COVID-19 outbreaks in nursing homes.

“What we need – now more than ever – is for our government leaders and lab companies from the private sector to work together to find a solution to prioritize and expedite the processing of tests for nursing home residents and caregivers,” stated Mark Parkinson, President and CEO of the American Health Care Association and National Center for Assisted Living.

CMS also recently announced that it will resume all routine inspections for Medicare and Medicaid-certified providers and suppliers. The inspections were previously suspended to prioritize infection control and immediate jeopardy surveys during the public health emergency.