• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • Donate Now
  • Sign Up

Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

  • Eligibility/Enrollment
  • Coverage/Appeals
    • Medicare Costs (2021)
    • Self Help Materials – Toolkits & More
  • Topics
    • Basic Introduction to Medicare
    • COVID-19 and Medicare
    • Medicare Costs (2021)
    • Home Health Care
    • Improvement Standard and Jimmo News
    • Nursing Home / Skilled Nursing Facility Care
    • Outpatient Observation Status
    • Part B
    • Part D / Prescription Drug Benefits
    • Medicare for People Under 65
    • Medicare “Reform”
    • All Other Topics
    • Resources
      • Infographics
  • Publications
    • CMA Alerts
    • Fact Sheets & Issue Briefs
    • Infographics
    • The Medicare Handbook
    • SNF Enforcement Newsletter
    • Elder Justice Newsletter
    • Medicare Facts & Fiction
    • Articles by Topic
  • Litigation
    • Litigation News
    • Cases
    • Litigation Archive
    • Amicus Curiae Activities
  • Newsroom
    • Press Releases
    • Editorials & Letters to the Editor
    • CMA Comments, Responses, and Letters
    • Medicare Facts & Fiction
    • CMA in the News
  • About Us
    • Mission Statement
    • CMA FAQs
    • Personnel & Boards
    • The Center for Medicare Advocacy Founder’s Circle
    • Connecticut Dually Eligible Appeals Project
    • Ossen Medicare Outreach, Education and Advocacy Project
    • National Medicare Advocates Alliance
    • National Voices of Medicare Summit
    • CMA Webinars
    • Products & Services
    • Testimonials
    • Career, Fellowship & Internship Opportunities
    • Contact Us
  • Support Our Work
    • Donate Now
    • Join the Center for Medicare Advocacy Founder’s Circle
    • Take Action
    • Share Your Health Care Story
    • Tell Congress to Protect Our Care
    • Listen to Medicare & Health Care Stories
    • Sign Up

Infection Control Surveys In Nursing Facilities: As Deaths Soar, CMS Reports Few Deficiencies, Primarily “No Harm”

November 12, 2020

Print Friendly, PDF & Email

In March 2020, the Centers for Medicare & Medicaid Services (CMS) suspended the regular survey process and announced that it would conduct limited surveys that focused on infection prevention and control issues.[1]  Since June, CMS has made information about these limited surveys publicly available, on the last Wednesday of each month, through the federal website Nursing Home Compare.  The Center for Medicare Advocacy has analyzed these survey data each month and issued reports describing the findings.  While the total number of surveys has dramatically increased, now totaling more than 40,000, the findings are virtually the same each month. 

For six months, CMS has reported that fewer than 3% of the surveys have cited infection control deficiencies, and that the overwhelming majority of deficiencies have been classified as no-harm.  A second publicly-available CMS website, Quality, Certification and Oversight Reports (QCOR), reports data about surveys, deficiencies, and civil money penalties.  The two publicly-available data sets are not consistent with each other, reporting different information about surveys and deficiencies.[2]  Adding to the confusion about surveys and infection control deficiencies is reporting by newspapers and state departments of health about deficiencies and penalties that do not appear on the publicly available federal websites.

Another point of confusion was CMS’s report, on August 14, 2020, that it had cited more than 180 “immediate jeopardy” level deficiencies for infection prevention and control at nursing facilities, triple the rate from 2019, and that it had imposed civil money penalties exceeding $10 million for the deficiencies.[3]  CMS acknowledged in a call with nursing home residents’ advocates on August 19 that the data reported on August 14 were available only in an internal CMS database, not on its two publicly-reported databases.  Even now, however, nearly three months after CMS’s announcement, the publicly-reported information does not support CMS’s claims about deficiencies or penalties.

Changes in surveys continue.  In August, CMS announced that states should gradually begin conducting standard surveys.[4]  These survey results are intermingled with the focused infection control surveys.

This report discusses both the sixth cumulative release of focused infection control surveys (reported by CMS on October 28) and, separately, data for the month of September. 

Cumulative survey data

As of October 28, Nursing Home Compare indicates that state survey agencies had conducted 40,144 surveys and cited 1104 deficiencies (2.8%) for infection control (F-880). 

The number and percentage of immediate jeopardy infection control survey have increased with each cumulative survey, but remain a small number and percentage of facilities that have had surveys.

Date of CMS releaseTotal number of surveys reportedTotal number (percent) of infection control deficiencies citedTotal number (percent) of immediate jeopardy deficiencies cited
June 4   5,724   163 (2.8%)   1 (1.0%)
June 24   9,899   262 (2.6%)   4 (1.5%)
July 29 16,987   347 (2.0%) 22 (6.6%)
August 26 25,593   556 (2.2%)  48 (8.6%)
September 30 32,681   777 (2.4%)  75 (9.7%)
October 28 40,1441,104 (2.8%)112 (10.1%)

Most infection control deficiencies are classified as no harm.  Of the 1,104 deficiencies, 983 (89.0%) are classified as “no actual harm with the potential for no more than minimal harm” – i.e., “no harm.”  Only 112 of the 1104 F-880 deficiencies (10.1%) are classified as immediate jeopardy.

Each of the six cumulative surveys has cited most of the infection control deficiencies as “no harm” – levels D, E, and F.

Scope and Severity of F-880 Deficiencies
Cumulative Data (Oct. 28, 2020)

As categorized by the combined scope and severity classifications, most deficiencies (983 of 1,104 deficiencies, 89.0%) are cited as “minimal harm or potential for actual harm” (levels D, E, and F), also known as “no harm.”

September Surveys

In September, state survey agencies conducted 3855 surveys.  Only 27 surveys (.007%) cited an infection control deficiency.  All 27 infection control deficiencies were classified as “no harm.”

Conclusion

As COVID-19 cases increase in nursing facilities nationwide and residents and staff die, CMS continues to report that surveys cite few deficiencies and classify most of them as “no-harm,” meaning no enforcement. 

November 12, 2020 – M. Edelman, T. Edelman


[1]  CMS, “Suspension of Survey Activities,” QSO-20-12-All (Mar. 4, 2020), https://www.cms.gov/files/document/qso-20-12-all.pdf; CMS, ‘Prioritization of Survey Activities,” QSO-20-20-All (Mar. 23, 2020), https://www.cms.gov/files/document/qso-20-20-all.pdf.

[2] “Infection Control Surveys At Nursing Facilities” (CMA Alert, Oct. 29, 2020), https://medicareadvocacy.org/infection-control-surveys-at-nursing-facilities/. 

[3] CMS, “Trump Administration Has Issued More Than $15 Million in Fines to Nursing Homes During COVID-19 Pandemic” (Press Release, Aug. 14, 2020), https://www.cms.gov/newsroom/press-releases/trump-administration-has-issued-more-15-million-fines-nursing-homes-during-covid-19-pandemic.

[4] CMS, “Enforcement Cases Held during the Prioritization Period and Revised Survey Prioritization,” QSO-20-35-ALL (Aug. 17, 2020), https://www.cms.gov/files/document/qso-20-35-all.pdf.

Filed Under: Article Tagged With: alert, enforcement, Skilled Nursing Facility, snf, Weekly Alert

Primary Sidebar

Easy Access to Understanding Medicare

The Center for Medicare Advocacy produces a range of informative materials on Medicare-related topics. Check them out:

  • Medicare Basics
  • CMA Alerts
  • CMA Webinars
  • Connecticut Info & Projects
  • Health Care Stories
  • Se habla Español

Sign Up for CMA Alerts

Jimmo v. Sebelius

Medicare covers skilled care to maintain or slow decline as well as to improve.

Improvement Isn’t Required. It’s the law!

Read more.

Medicare: Build Back Better

By prioritizing Medicare beneficiaries and the health systems that serve them, we can avoid drastic national consequences. The Center for Medicare Advocacy proposes a five-part plan that will make Medicare a bulwark against the worsening health and economic challenges facing the American people.

learn more.

Latest Tweets

  • RT @johnahartford: Celebrate 35 Years of Medicare Advocacy and attend the 8th Annual National Voices of Medicare Summit & Sen. Jay Ro… https://t.co/OfBcjmtYo0, 12 hours ago
@CMAorg

Footer

Stay Connected:

  • Contact Us
  • Sitemap
  • Products & Services
  • Copyright/Privacy

© 2021 · Center for Medicare Advocacy