CMS May Take Back CARES Funding if Nursing Home Inspection Rates Do Not Improve

In response to low inspection rates, the Centers for Medicare and Medicaid Services (CMS) has announced they are taking a series of steps to address inspection rate deficiencies and other challenges facing nursing homes in their response to COVID-19. In data released on June 1, 2020, CMS reported 25,923 deaths nursing home resident COVID-19 deaths and 60,439 COVID-19 cases. Due to gaps in the data collection and other methodology issues, this number is considered an undercount of actual COVID-19 nursing home deaths.

CMS announced the following actions:

Supplemental Funding at Risk if Inspections Not Completed in Timely Manner

CMS will recoup certain Coronavirus Aid, Relief, and Economic Security Act (CARES Act) funding if inspections are not completed by designated dates.

Through the CARES Act, CMS received $80 million to give to states to spend on nursing home inspections and other related activities. States that have not completed 100% of focused infection control surveys of their nursing home by July 31, 2020, will be required to submit a corrective action plan outlining their strategy for completing these surveys within 30 days.  If, after the 30-day period, states have still not performed surveys in 100% of nursing homes, their CARES Act fiscal year 2021 allocation may be reduced by 10%.  Subsequent 30-day extensions could result in an additional 5% reduction. These funds would then be redistributed to those states that completed 100% of their focused infection control surveys by July 31.

Deployment of Quality Improvement Organizations (QIOs)

CMS has strategically refocused QIOs to assist nursing homes in combating COVID-19 within these facilities. QIOs are being deployed to provide technical assistance to nursing homes, which includes a targeted focus on approximately 3,000 low performing nursing homes who have a history of infection control challenges. Further, States may request QIO technical assistance specifically targeted to nursing homes that have experienced an outbreak.

Expanding Survey Activities as States Reopen

In March 2020, CMS announced that routine survey activities were paused to allow nursing homes to focus on infection control. As states are now beginning to reopen, in this announcement CMS is providing guidance for the limited resumption of routine survey activities.

 

______________________________________________________________________________

For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459/smadhani@mcdermottplus.com, Mara McDermott at 202-204-1462/mmcdermott@mcdermottplus.com or Rachel Stauffer at 202-204-1460/rstauffer@mcdermottplus.com.