• 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
    • Annual Report
    • 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

The Coronavirus and Nursing Home Residents

March 19, 2020

Print Friendly, PDF & Email

A Statement from the Center for Medicare Advocacy and the Long Term Care Community Coalition

March 19, 2020—At least twenty-six residents at Life Care Centers at Kirkland have died of the coronavirus and many more residents and staff at the Washington State nursing facility are showing signs of the illness. Why have these medically fragile residents died at a health care facility that is supposed to provide safe and effective care to frail, medically compromised people? One troubling reason: Regulations for infection control are ignored and there is, typically, little enforcement when facilities violate them.

In October 2016, the Centers for Medicare & Medicaid Services (CMS), the federal agency that regulates nursing facilities, updated the regulations that govern nursing homes receiving public reimbursement through the Medicare and Medicaid programs, a category that includes nearly every nursing facility in the country. Citing statistics that residents of nursing facilities and other institutional settings develop millions of infections each year, with hundreds of thousands of them hospitalized and many dying, CMS reiterated long-standing requirements that nursing facilities have infection prevention and control programs. In addition, the Administration created a new staff position – infection preventionist – in order to have a health care professional with the necessary skills and training on-site overseeing each facility’s infection prevention and control program. The rules for the infection prevention and control program went into effect in November 2016. Facilities were given three years – until November 2019 – to prepare for the infection preventionist requirement.

In March 2019, CMS announced that along with the Centers for Disease Control and Prevention (CDC), it had developed a free on-line training program for intervention preventionists. In November 2019, CMS reminded facilities and states of federal infection control resources and sent out a self-assessment tool for facilities to determine how well or how poorly they were doing in meeting infection prevention and control requirements.

So what’s wrong? After all, infection control is the care problem that is most frequently cited by the state survey teams that inspect nursing homes to determine whether they meet federal standards.

The problem is that the federal standards for infection prevention and control are treated as unimportant and, as a result, they are not enforced. Less than 1% of the 13,239 infection control deficiencies cited at nursing facilities since November 2017 have been cited at a level (actual harm or immediate jeopardy) that would typically lead to a meaningful enforcement action. The remaining 99+% of infection control deficiencies (called substantial compliance or no harm) are unlikely to lead to any financial penalty. In other words, nothing happens to most facilities that have an infection control deficiency; the government just says, fix the problem. To make matters worse, CMS recently proposed rolling back the infection preventionist requirements, signaling the Trump Administration’s ongoing commitment to reducing “provider burden.”

From its earliest days, the Trump Administration has listened to the urgings of the nursing home industry to reduce enforcement of federal standards of care – shifting from per day fines to much smaller per instance fines, reducing the number of days a per day fine can be imposed, expanding facilities’ ability to describe fines as unaffordable (and thus evade them), and more. Ultimately, residents, their families, and taxpayers pay the price for poor care that is allowed to persist.

Having meaningful standards of care is essential. But unless there are actual consequences for facilities that fail to meet the standards – and fail to provide high quality of care to residents that federal law promises – we will continue to see the tragedies that fill the newspapers each day.

In 2018, 11 children at a New Jersey nursing facility died of infections; the facility had been cited with a no-harm infection control deficiency at its most recent survey. Now, twenty-six older residents in a Washington State nursing facility have died and more residents and staff are sick. A fully implemented and properly functioning infection prevention and control program does not guarantee that infections will never occur, but it could help minimize the impact of the coronavirus pandemic and save lives.

Health and safety regulations are not burdensome interference with private business.  Health and safety regulations have a purpose; they are critical for protecting us and our communities. 

Additional Resources:

  • LTCCC’s Coronavirus webpage
  • Consumer Voice’s Supporting Coronavirus Prevention in LTC Facilities webpage
  • CDC’s guidance for LTC facilities

 

Filed Under: Article Tagged With: alert, 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

  • .@CMAorg is grateful to @johnahartford for the many years of ongoing support and for sponsoring this year’s Sen. Ja… https://t.co/5m2bEvignf, Mar 5
@CMAorg

Footer

Stay Connected:

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

© 2021 · Center for Medicare Advocacy