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Global cases are approaching 100,000 as the U.S. braces for the worst.

The Centers for Medicare & Medicaid Services (CMS) has suspended non-emergency facility inspections nationwide as a measure to free up resources to focus more acutely on the COVID-19 respiratory virus, officials announced on Wednesday.

“CMS is committed to taking critical steps to ensure America’s healthcare facilities and clinical laboratories are prepared to respond to the threat,” the agency said in a memorandum posted to its website, adding that the move is intended to allow “inspectors to turn their focus on the most serious health and safety threats.”

The number of cases of so-called coronavirus is reportedly approaching 100,000 worldwide, resulting in more than 3,000 deaths, with the vast majority of both thus far occurring in mainland China.

But with more than 150 cases and 11 deaths reported in the U.S. to date, including multiple patients in major metropolitan centers such as Seattle and New York City, government and healthcare authorities are bracing for what’s next. The U.S. House of Representatives reportedly voted 415-2 on Wednesday to approve $8.3 billion in federal emergency funding to address the issue nationwide, and the legislation is expected to be approved by the Senate by week’s end en route to the President’s desk.  

CMS’s memo was forwarded to state survey agencies, providing guidelines indicating that effective immediately, survey activity was limited to the following, in priority order:

  • All immediate jeopardy complaints (cases that represent a situation in which entity noncompliance has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment, or death or harm) and allegations of abuse and neglect;
  • Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses;
  • Statutorily required recertification surveys (Nursing Home, Home Health, Hospice, and ICF/IID facilities);
  • Any re-visits necessary to resolve current enforcement actions;
  • Initial certifications;
  • Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years; and
  • Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.

The memo also features protocols for the “coordination and investigation of facilities with actual or suspected COVID-19 cases,” noting that whenever a confirmed or presumptive positive case presents to any Medicare- or Medicaid-certified provider, state survey agencies are being asked to immediately do the following: 

  • Notify the appropriate CMS Regional Office (if they are not already aware) of the facility and date of patient/resident COVID-19 or presumptive respiratory illness or confirmed status;
  • Coordinate on initiating any federal complaint or recertification survey of the impacted facility until CDC (the Centers for Disease Control and Prevention, and any other relevant federal/state/local response agencies) have cleared the facility for survey. The CMS Regional Office will then authorize a survey, if necessary;
  • Ensure surveyors have all necessary personal protective equipment (PPE) appropriate to allow a survey of the facility; refer to CDC infection control resources for the most up-to-date guidance; and
  • Suspend any federal enforcement action for any deficiencies identified until reviewed and approved by the CMS Regional Office to ensure consistent and appropriate action.

“These protocols will be updated as circumstances warrant,” CMS added in the memo. “We are asking accrediting organizations to copy their CMS AO liaison on any communications with the CMS Regional Office.”

To review the memo in its entirety, go online to https://www.cms.gov/files/document/qso-20-12-allpdf.pdf-1.

CMS also indicated that it will be posting updated FAQs on the coronavirus response in real-time at the following website: https://www.cms.gov/medicare/quality-safety-oversight-generalinformation/coronavirus


Mark Spivey

Mark Spivey is a national correspondent for RACmonitor.com, ICD10monitor.com, and Auditor Monitor who has been writing and editing material about the federal oversight of American healthcare for more than a decade.

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