CMS to strengthen COVID-19 surveillance requirements for nursing homes

Key Takeaways

On April 19, the Centers for Medicare and Medicaid Services (CMS) released a new memo, titled “Upcoming Requirements for Notification of Confirmed COVID-19 (or COVID-19 Persons under Investigation) Among Residents and Staff in Nursing Homes.” The document outlines new regulations being issued by CMS to improve nursing homes’ surveillance of communicable diseases, as COVID-19 cases surge in long-term care facilities across the country. The new regulations are expected to impact counties, which provide critical health services through 824 county-supported nursing homes and long-term care facilities.

The new requirements largely center around reporting new cases of COVID-19. Under the new regulations, nursing homes will be required to inform residents, their families and their representatives when residents or staff contract the coronavirus. This notification must come within 12 hours of a confirmed single case of the disease, and residents, families and representatives must be told when three or more individuals develop respiratory symptoms within a 72-hour period. Nursing home facilities will additionally be required to include information on steps they are taking to prevent and reduce transmission of the disease. These reporting requirements will be subject to existing federal privacy laws, including the 42 CFR Part 2 rule governing confidentiality of patient health records.

In addition to new reporting guidelines, the rules will also direct nursing homes to report coronavirus cases to the Centers for Disease Control and Prevention (CDC) as part of an effort to improve nationwide data-tracking of the illness. Under current federal guidelines, nursing homes must report this data to state and local health departments.

The release of CMS’ plan comes shortly following the enactment of three legislative packages to mitigate the public health and economic impacts of COVID-19. As passed, the three bills contain multiple new supports for health care programs important to counties, including funding to support the health care workforce and enhanced education and training for health care professionals in geriatrics. Congress and federal agencies are currently weighing next steps in the federal response to the pandemic, with plans announced for passage of a fourth package. As congressional legislators make progress on these plans, agency officials will continue to issue guidance on the federal programs and funding outlined under the legislative response to the pandemic.

For additional information, please see the following links:

• Centers for Medicare and Medicaid Services (CMS): Upcoming Requirements for Notification of Confirmed COVID-19 Among Residents and Staff in Nursing Homes (CMS memo)
• Letter to Congress: County Priorities in Legislation to Address the COVID-19 Pandemic (NACo letter to Capitol Hill on April 13)
• Analysis of the Third COVID-19 Supplemental: The Coronavirus Aid, Relief and Economic Security Act (NACo legislative analysis)
• County Governments and COVID-19: Key Issues and Resources (NACo legislative brief)