Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

CMA Special Report – Infection Control Surveys at Nursing Facilities: It Looks Like Business as Usual

Print Friendly, PDF & Email

 

When the Centers for Medicare & Medicaid Services (CMS) suspended the regular survey system for nursing facilities during the COVID-19 crisis, it reported that, for a three-week prioritization period (beginning March 20) and since extended until further notice, it would suspend regular survey activities and conduct only two types of surveys: (1) complaints and facility-reported incidents that are triaged by the state survey agency as immediate jeopardy and (2) infection control surveys.

Historically, infection control deficiencies are cited at nearly two out of three nursing facilities in the country, making infection prevention and control the most frequently-cited problem in nursing homes nationwide. However, less than one percent of the deficiencies are classified as actual harm or immediate jeopardy; more than 99% are called “no harm.”

CMS sent advocates 169 infection control surveys that were conducted in 20 states between March 25 and April 21 and two additional infection control surveys that were conducted earlier in March.  In reviewing those surveys, we found:

  • 130 of the 171 infection control surveys (76%) did not identify an infection control problem at all.
  • Of the 41 surveys that cited an infection control deficiency, 30 surveys (73%) described the deficiency as “no harm.”
  • 8 surveys (.05%) initially cited the infection control deficiency as immediate jeopardy, but jeopardy was removed or reduced to a no-harm deficiency during the course of the survey (although one of the surveys, conducted in Washington State, was earlier than March 20).
  • Only 3 of 171 surveys (.02%) cited immediate jeopardy (although one of the surveys, conducted in Washington State on March 16, was the Life Care Center of Kirkland, the first nursing facility in the country where coronavirus was identified).

Final regulations published October 2016, if effectively implemented and enforced, could reduce residents’ infections and hospitalizations, save residents’ lives, and save Medicare billions of dollars. Clearly, the infection control surveys show that we can and must do better at identifying infection prevention and control deficiencies and treating them seriously.

May 7, 2020 – T. Edelman