Webinar Dec 3 | Patient-Centered QI and System Design

From Firstwatch, Prodigy EMS, and the Center for Patient Safety

Conversations that Matter:
Patient-Centered QI and System Design
December 3, 2020 | Noon ET | Learn More & Register►

Most EMS systems claim to put the patient first, yet they still work 24-hour shifts, drive ambulances designed so that patients face the rear, and have QI systems that are not connected to the rest of the healthcare system.

Join us for this installment of Conversations that Matter, when facilitator Mike Taigman will explore how to create a more patient- and people-centered EMS organization with Jeff Jarvis, MD, MS, EMT-P, medical director for Williamson County EMS and Marble Falls Area EMS; former paramedic and hospital executive Bill Atkinson, PhD, EMT-P; and Brian LaCroix, EMS coordinator with the Center for Patient Safety. This session is sure to expand your knowledge and may just challenge your beliefs in the process.

Register on Prodigy EMS

Host – Mike Taigman, MA

Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care and service they provide to patients and their communities. Mike is the improvement guide for FirstWatch and a nationally recognized author and speaker. He was the facilitator for the national EMS Agenda 2050 project and teaches improvement science in the Master’s in Healthcare Administration and Interprofessional Leadership program at the University of California San Francisco. He will serve as host and facilitator for Conversations that Matter.

Jeff Jarvis, MD, MS, EMT-P

Jeff Jarvis, MD, MS, EMT-P, is the medical director for Williamson County EMS and Marble Falls Area EMS. He is a practicing emergency physician at Baylor Scott & White Hospital in Round Rock, Texas. His experience in EMS and the broader health care field spans over 30 years, beginning as a volunteer firefighter and EMT. He has served as a paramedic in three states, the Texas State EMS training coordinator and department chair of EMS Technology at Temple College. Dr. Jarvis served as a member of the EMS Agenda 2050 Technical Expert Panel and represents the American College of Emergency Physicians on the National EMS Quality Alliance Steering Committee.

Bill Atkinson, PhD, EMT-P

Bill Atkinson, PhD, EMT-P, is president of Guidon Healthcare Consulting in Raleigh, North Carolina. He began his career in healthcare leadership as one of the first EMTs and then paramedics in the state of North Carolina. Dr. Atkinson went on to a lengthy career in healthcare management, running hospitals in South Carolina, Texas and Colorado before returning home to serve as president and CEO of New Hanover Regional Medical Center and, from 2003 until his retirement in 2013, WakeMed Health and Hospitals.

Brian LaCroix

Brian LaCroix serves as EMS coordinator with the Center for Patient Safety. He recently retired as president and EMS chief of Allina Health EMS in St. Paul, Minnesota, where had started as a field provider in 1997. LaCroix also served as the president of the National EMS Management Association, is a fellow in the American College of Paramedic Executives and holds a paramedic degree and a bachelor’s degree in business administration. HE also consults with organizations to recruit senior EMS leaders, develop individuals and grow leadership teams and has worked on extended international EMS projects in Nicaragua, France and Croatia.

Center for Patient Safety

The Center for Patient Safety (CPS) provides expert support and resources across the healthcare continuum in our mission to reduce preventable harm.

For paramedicine providers CPS helps agencies cultivate a Culture of Patient Safety, manages a robust Patient Safety Organization for providers, offers education and support of mental and well-being of providers.

The Center is honored to be supporting the important dialogue of “Conversations that Matter!”

Webinar | EMS Performance: NEMSQA Quality Measures

EMS Performance: NEMSQA Quality Measures Webinar
December 3, 2020 | 15:00 ET | Register Now►

Performance measures drive practice, protocols, spending, and behaviors across healthcare. The National EMS Quality Alliance (NEMSQA) is leading the charge in development, refinement and dissemination of quality and performance measures for EMS. Working with EMS organizations, stakeholders, partners from government and industry, NEMSQA updated the EMS Compass measures to ensure their evidence-basis and make them readily deployable across the EMS community to drive quality and improvement in patient care. This program will inform you about the work of NEMSQA, how the NEMSQA measures are being implemented already, and how you can employ NEMSQA measures to improve performance in your EMS service or region.

Register Now

NEMSQA Mission Statement
NEMSQA will develop and endorse evidence-based quality measures for EMS and healthcare partners that improve the experience and outcomes of patients and care providers.

NEMSQA Vision Statement
Improving patient outcomes through the collaborative development of quality measures for EMS and health systems of care.

NIH | Promising Interim Results from NIH-Moderna Vaccine

From the National Institutes of Health on November 16

Promising Interim Results from Clinical Trial of NIH-Moderna COVID-19 Vaccine

An independent data and safety monitoring board (DSMB) overseeing the Phase 3 trial of the investigational COVID-19 vaccine known as mRNA-1273 reviewed trial data and shared its interim analysis with the trial oversight group on Nov. 15, 2020. This interim review of the data suggests that the vaccine is safe and effective at preventing symptomatic COVID-19 in adults. The interim analysis comprised 95 cases of symptomatic COVID-19 among volunteers. The DSMB reported that the candidate was safe and well-tolerated and noted a vaccine efficacy rate of 94.5%. The findings are statistically significant, meaning they are likely not due to chance. 90 of the cases occurred in the placebo group and 5 occurred in the vaccinated group. There were 11 cases of severe COVID-19 out of the 95 total, all of which occurred in the placebo group.

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2020 AHA CPR Guidelines Released

From the American Heart Association’s Circulation Journal on October 21

The 2020 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care provides a comprehensive review of evidence-based recommendations for resuscitation and emergency cardiovascular care. The initial guidelines for CPR were published in 1966 by an ad hoc CPR Committee of the Division of Medical Sciences, National Academy of Sciences—National Research Council.1 This occurred in response to requests from several organizations and agencies about the need for standards and guidelines regarding training and response.

Since then, CPR guidelines have been reviewed, updated, and published periodically by the AHA.2–9 In 2015, the process of 5-year updates was transitioned to an online format that uses a continuous evidence evaluation process rather than periodic reviews. This allowed for significant changes in science to be reviewed in an expedited manner and then incorporated directly into the guidelines if deemed appropriate. The intent was that this would increase the potential for more immediate transitions from guidelines to bedside. The approach for this 2020 guidelines document reflects alignment with the International Liaison Committee on Resuscitation (ILCOR) and associated member councils and includes varying levels of evidence reviews specific to the scientific questions considered of greatest clinical significance and new evidence.

Read the 2020 Guidelines

 

October 16 is World Restart a Heart Day

From the Citizen CPR Foundation

The Citizen CPR Foundation’s 40 Under 40 Committee have combined talents and resources to produce a video featuring sudden cardiac arrest (SCA) survivors under 40 years of age. The video highlights the fact that sudden cardiac arrest can strike anyone, at any age, at any time – and that it should not be confused with a heart attack.

“There are too many people outside of our field who don’t understand the difference between a heart attack and a sudden cardiac arrest. Sadly, this also means they probably don’t know how to respond when it happens right in front of them – often to someone they know or love dearly,” says Stu Berger, MD, Foundation President and Division Head, Cardiology, at Ann & Robert H. Lurie Children’s Hospital of Chicago.

“One of the first issues the 40 Under 40 committee decided to work on after being formed in 2020 is sudden cardiac arrest awareness. This video was created to educate the public on cardiac arrest and inspire them to act if/when the time comes. I was 26 years old when I suffered my cardiac arrest. I was saved by my wife and a fellow police officer who both did incredible CPR until Fire/EMS could arrive and successfully resuscitate me. I am alive today earning my second chance at life because my wife and the responding officer did not hesitate to act” says Officer Brandon Griffith, 40 under 40 committee member, SCA survivor, and project lead on the video production.

Griffith continues, “We feature actual out of hospital sudden cardiac arrest survivors under the age of 40 to not only tackle stigmas of SCA but to highlight that it can happen to anyone, anywhere, anytime. With cardiac arrest, every second counts. Knowing how to recognize SCA and properly react can significantly increase survival outcomes.”

The video stresses and plays out the chain of survival steps necessary to save the life of someone suffering SCA: call 911, start compressions hard and fast in the center of the chest, use an AED if available, and don’t stop until first responders arrive and take over medical care. In other words, “Don’t wait, ACT!” as the video highlights.

View the video here:  https://citizencpr.org/actnow/

The launch coincides with World Restart a Heart day, a worldwide call to action on October 16th that is issued by the International Liaison Committee on Resuscitation.

The Foundation’s 40 Under 40 Program is supported in part by its Partner Council, a collaboration of committed, mission-aligned businesses and non-profits. It includes the American Heart Association and the American Red Cross, with support from industry including AED Superstore, Laerdal Medical, MD Solutions International, Nasco Healthcare, Prestan Products, Save Station, WorldPoint and ZOLL.

About Citizen CPR Foundation 

Founded in 1987, the mission of Citizen CPR Foundation is to save lives from sudden cardiac arrest by stimulating effective community, professional and citizen action. Every two years, the foundation holds its international Cardiac Arrest Survival Summit, formerly the Emergency Cardiovascular Care Update (ECCU), which features the latest information and trends in cardiopulmonary resuscitation (CPR). They will host their first ever Virtual Summit December 8 & 9, 2020. Register here: https://www.wregistration.com/ereg/index.php?eventid=579171& Contact Jennifer Crocker at 816-916-6843 or jcrocker@wellingtonexperience.com for more information.

 

CMS: Revised Repayment Terms for Medicare Accelerated Payments

On October 8, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a Fact Sheet setting forth the repayment terms for advances made under the Medicare Accelerated and Advance Payments Program (AAPP).  These changes were mandated by the passage of the Continuing Appropriations Act, 2021 and Other Extensions Act, which was enacted on October 1, 2020.

Background

On March 28, 2020, CMS expanded the existing Accelerated and Advance Payments Program to provide relief to Medicare providers and suppliers that were experiencing cash flow disruptions as a result of the COVID-19 pandemic, and associated economic lockdowns.  Under the AAPP, Medicare providers and suppliers were eligible to receive an advance of up to three months of their historic Medicare payments.  These advances are structured as “loans,” and are required to be repaid through the offset of future Medicare payments.

CMS began accepting applications for Medicare advances in mid-March 2020, before ending the program in late April following the passage of the CARES Act.  CMS ultimately approved more than 45,000 applications for advances totaling approximately $100 billion, before it suspended the program in late April 2020.

Under the pre-existing terms of the AAPP, repayment through offset was required to commence on the 121st day following the provider or supplier’s receipt of the advance funds.  The program also called for a 100% offset until all advanced funds had been repaid.

Revised Payment Terms

Under the revised payment terms announced by CMS, providers and suppliers will not be subject to recoupment of their Medicare payments for a period of one year from the date they received their AAPP payment.  Starting on the date that is one year from their receipt of the AAPP payment, repayment will be made out of the provider’s or supplier’s future Medicare payments.  The schedule for such repayments will be as follows:

  • 25% of the provider’s or supplier’s Medicare payments will be offset against the outstanding AAPP balance for the next eleven (5) months; and
  • 50% of the provider’s or supplier’s Medicare payments will be offset against the outstanding AAPP balance for the next six (6) months

To the extent there remains an outstanding AAPP balance after that 17 month period (i.e., 29 months after the date the provider or supplier received its AAPP payment, the provider or supplier will receive a letter setting forth their remaining balance.  The provider or supplier will have 30 days from the date of that letter to repay the AAPP balance in full.  To the extent the AAPP balance is not repaid in full within that 30-day period, interest will begin to accrue on the unpaid balance at a rate of 4%, starting from the date of the letter.

Medicare providers and suppliers are also permitted to repay their accelerated or advance payments at any time by contacting their Medicare Administrative Contractor.

 

EMS.gov | Public Comment for EMS Controlled Substances Rule

From EMS.gov

Public Comment Period for Proposed Rule on EMS and Controlled Substances

As part of the Protecting Patient Access to Emergency Medications Act of 2017, which was passed 3 years ago, the DEA was required to establish regulations associated with the use of controlled substances by EMS agencies. The DEA has now published in the Federal Register proposed rules to implement the law. Comments on the proposed rules can be submitted electronically or by mail on or before December 4, 2020. Individuals, agencies and organizations may submit comments.

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CMS Updates Medicare COVID-19 Snapshot

From CMS on October 2, 2020

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 1 million COVID-19 cases among the Medicare population and over 284,000 COVID-19 hospitalizations.

Other key findings:

  • The rate of COVID-19 cases among Medicare beneficiaries grew 30% since the August release to 1,562 cases per 100,000 beneficiaries.
  • Similarly, the rate of COVID-19 hospitalizations among Medicare beneficiaries grew 32% since the August release to 444 hospitalizations per 100,000 beneficiaries.
  • The rate of COVID-19 cases and hospitalizations grew the most among rural beneficiaries, Hispanic beneficiaries, and Medicare-only beneficiaries (those who are not dually eligible for Medicaid).
  • Medicare Fee-for-Service (Original Medicare) spending associated with COVID-19 hospitalizations grew to $4.4 billion or just under $25,000 per hospitalization.
  • Data on discharge status and length of stay for COVID-19 hospitalizations remained similar to previously reported figures in the August release. 31% of beneficiaries went home at the end of their hospital stay and 22% died. Nearly half of the hospitalizations lasted 7 days or less while 5% lasted more than 31 days.

The updated data on COVID-19 cases and hospitalizations among Medicare beneficiaries covers the period from January 1 to August 15, 2020. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by September 11, 2020.

JEMS | How Empress EMS (NY) Responded to COVID-19 in the Pandemic’s Epicenter

From JEMS on October 2, 2020 | By Hanan Cohen

The onset of the COVID-19 pandemic created extraordinary new challenges for the emergency medical services (EMS) industry. Frequently shifting state and federal guidance and emerging information about the novel virus has required EMS agencies to be even more nimble in delivering care.

This is true for Empress EMS, a PatientCare EMS Solutions company, which serves New Rochelle, New York – the first epicenter of America’s COVID-19 pandemic. Empress first began monitoring for COVID-19 on February 15, 2020, as it recognized the New York City area’s high risk for the virus.

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CMS: COVID Testing and Screening Guidance for SNF and Long-Term Care Facilities

On August 25, 2020, the Centers for Medicare and Medicaid Services (CMS) published an interim final rule with a comment period titled “Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments of 1988 (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency.”  The interim final rule sets forth a number of new requirements designed to limit the COVID-19 exposure and to prevent the spread of COVID-19 within nursing homes.

Specifically, the interim final rule requires skilled nursing and other long-term care facilities to test residents and staff for COVID-19.  The frequency of such testing is based on the positivity rate in which the facility is located, and can require COVID-19 testing as frequently as twice per week.  Regardless of the frequency of required COVID-19 tests, facilities must also screen all staff, residents, and persons entering the facility for the signs and symptoms of COVID-19.

These requirements extend to individuals that provide services to nursing homes under arrangements, including health care personnel rendering care to residents within the facility.  In subsequent guidance, CMS clarified that these testing and screening requirements apply to EMS personnel and other health care providers that render care to residents within the facility.  However, in that same guidance, CMS indicated that EMS personnel must be permitted to enter the facility provided that: (1) they are not subject to a work exclusion as a result of to an exposure to COVID-19 or (2) showing signs or symptoms of COVID-19 after being screened.”  CMS further indicated that “EMS personnel do not need to be screened so they can attend to an emergency without delay.”

In plain terms, CMS has created an affirmative obligation on nursing homes to ensure that any individual that provides services under a contractual arrangement with the nursing home comply with these testing and screening requirements.  CMS has expressly waived the screening requirements for EMS personnel responding to medical emergencies at a nursing home.  However, CMS has not specifically addressed the testing and screening requirements applicable to EMS personnel responding to nursing homes in non-emergency situations. 

The A.A.A. is aware that a handful of State Health Agencies have issued their own guidance on this issue.  The A.A.A. is also aware that individual nursing homes have started to require proof that EMS personnel have been tested for COVID-19 prior to allowing these individuals to enter the nursing home in a non-emergency situation.

EMS agencies may already be subject to state and local testing mandates.  EMS agencies may also have their own internal policies that require employees to be periodically tested for COVID-19.  As a result, there exists the potential for conflict where these existing testing policies conflict with the testing requirements of your local nursing homes.

The A.A.A. has been engaged in an ongoing conversation with CMS on these issues since the issuance of the interim final rule in August.  As part of that conversation, the A.A.A. pushed for the exclusion of EMS personnel from the screening requirement when responding to medical emergencies, which was included in the recent CMS guidance document.  The A.A.A. also continues to push for additional funding for COVID-19 testing for EMS agencies.  CMS has recognized that the frequent testing of health care workers is essential to reducing the spread of the novel coronavirus.  CMS has allocated funding for these purposes to other industries, including hospitals and nursing homes.  As front-line health care workers, EMS agencies should have similar access to testing funds.  The A.A.A. will continue to push for funding equity for the EMS industry.

In the interim, we strongly encourage our members to work with their state associations and other stakeholders to advocate for reasonable rules related to testing on the state and local levels.  To the extent the applicable state or local agency has determined the appropriate frequency for the testing of EMS personnel responding to medical emergencies, those rules should also apply to EMS personnel responding to scheduled transports and other non-emergencies that start or end at a nursing home.  Requiring more frequent testing in these situations would impose an undue burden on EMS agencies that provide these services.  More frequent testing may also prove counterproductive, as it may discourage EMS agencies that cannot meet these higher requirements from responding in these situations.  We also encourage our members to continue to push for state and local funding for the testing of their employees.

 

Update – SNF COVID-19 Testing Does Not Apply to EMS

CMS Clarify in Guidance that EMS Personnel Are Not Required To Be Tested under Skilled Nursing Facility Testing Interim Final Rule

The Centers for Medicare & Medicaid Services (CMS) have issued guidance clarifying the types of personnel who are subject to the testing requirements when entering a Skilled Nursing Facility (SNF) in the Interim Final Rule with Comment (IFC) on Additional Policy and Regulatory Revisions in Response to the COVID– 19 Public Health Emergency.  The new guidance memo states:

 

Entry of Health Care Workers and Other Providers of Services

Health care workers who are not employees of the facility but provide direct care to the facility’s residents, such as hospice workers, Emergency Medical Services (EMS) personnel, dialysis technicians, laboratory technicians, radiology technicians, social workers, clergy etc., must be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or show signs or symptoms of COVID-19 after being screened. We note that EMS personnel do not need to be screened so they can attend to an emergency without delay. We remind facilities that all staff, including individuals providing services under arrangement as well as volunteers, should adhere to the core principles of COVID-19 infection prevention and must comply with COVID-19 testing requirements.

 

CMS issued this guidance at the request of the American Ambulance Association (AAA) to address concerns our members had raised about some SNFs misinterpreting the requirements.  The guidance is also consistent with AAA’s interpretation of the IFC.   As we indicated in an earlier Member Advisory, the IFC requires SNFs to test certain individuals for COVID-19 before they enter the facility.  Specifically, it applies to employees, consultants, and contractors of a skilled nursing facility (SNF).  It does not apply to vendors, suppliers, attending physicians, family, or visitors. Providers, such as medical directors and hospice, that are under a contract or consultants to a SNF are subject to the rule.  EMS personnel do not come within the scope of the IFC.

 

Even though the testing requirements of the IFC do not extend to ground ambulance services that do not have a contractual relationship with a SNF, the AAA supports the efforts of all of our members to follow the World Health Organization and Centers for Disease Control and Prevention Guidelines to have EMT and paramedics use full Personal Protective Equipment (PPE) when they are engaging with any patient, not only those in SNFs.  We also want to recognize the best practices of many members who have worked with SNFs to establish outdoor locations where the SNF personnel, when possible, can bring a patient out of the building to transfer the patient to the ambulance.  These and other examples of safe practices can help control the spread of COVID-19, which is the paramount concern.

CMS | Independent Nursing Home COVID-19 Commission Findings Validate Unprecedented Federal Response

From the Centers for Medicare and Medicaid Services

Today, the Centers for Medicare & Medicaid Services (CMS) received the final report from the independent Coronavirus Commission for Safety and Quality in Nursing Homes (Commission), which was facilitated by MITRE.  CMS also released an overview of the robust public health actions the agency has taken to date to combat the spread of the coronavirus disease 2019 (COVID-19) in nursing homes. The Commission’s findings align with the actions the Trump Administration and CMS have taken to contain the spread of the virus and to safeguard nursing home residents from the ongoing threat of the COVID-19 pandemic. Today’s announcement delivers on the Administration’s commitments to keeping nursing home residents safe and to transparency for the American people in the face of this unprecedented pandemic.

The Trump Administration’s effort to protect the uniquely vulnerable residents of nursing homes from COVID-19 is nothing short of unprecedented,” said CMS Administrator Seema Verma. “In tasking a contractor to convene this independent Commission comprised of a broad range of experts and stakeholders, President Trump sought to refine our approach still further as we continue to battle the virus in the months to come. Its findings represent both an invaluable action plan for the future and a resounding vindication of our overall approach to date. We are grateful for the Commission’s important contribution.”

As the capstone to the Commission’s extensive report, tomorrow, Administrator Verma will join Vice President Mike Pence and the Centers for Disease Control and Prevention (CDC) Director Dr. Robert R. Redfield, some members of the Commission, and other public health and elder care experts at the White House. The Vice President, Dr. Redfield and Administrator Verma will lead the group in a discussion regarding the Commission’s findings and general issues facing the nation’s elder care system.

Nursing homes and other shared or congregate living facilities have been severely affected by COVID-19, as these facilities often house older individuals who suffer from multiple medical conditions, making them particularly susceptible to complications from the virus. To help CMS inform immediate and future actions as well as identify opportunities for improvement, the   Commission was created to conduct an independent review and comprehensive assessments of confronting COVID-19. The Commission’s report contains best practices that emphasize and reinforce CMS strategies and initiatives to ensure nursing home residents are protected from COVID-19.

As outlined in the overview released today, the Trump Administration has already taken significant steps to implement many of the Commission’s findings. The Administration has worked to support nursing homes financially during this challenging time, distributing over $21 billion to America’s nursing homes – more than $1.5 million each on average. To ensure nursing homes had access to supplies, the Trump Administration shipped a 14-day supply of personal protective equipment (PPE) to more than 15,000 nursing homes across the Nation in May.

The Administration has also required facilities to report data about COVID-19 cases, deaths, and supply levels, with 99.3 percent of facilities currently reporting. CMS took action to keep COVID-19 out of nursing homes by requiring them to test staff, a requirement that was paired with the Administration’s distribution of 13,850 point-of-care testing devices to America’s nursing homes. The Administration has also deployed federal Task Force Strike Teams in six waves, in 18 states so far, to 61 facilities particularly affected by COVID-19 to share best practices and gain a deeper understanding of how the virus spreads. CMS also required states to conduct focused infection control inspections at their nursing homes; between June and July, states completed these inspections at 99.8 percent of Medicare and Medicaid certified nursing homes.

Additionally, since March, CMS has conducted weekly calls with nursing homes, issued over 22 guidance documents and established a National Nursing Home COVID-19 Training program focused on infection control and best practices.  CMS is also using COVID-19 data to target support to the highest risk nursing homes. In May, CMS released a new toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to nursing homes.  The toolkit is a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19. CMS updates the toolkit on a biweekly basis.

To view the full independent Coronavirus Commission for Safety and Quality in Nursing Homes report, visit here:  cms.gov/files/document/covid-final-nh-commission-report.pdf

To view the Trump Administration Response to Commission findings, visit here: cms.gov/files/document/covid-independent-nursing-home-covid-19-federal-response.pdf

To view the COVID-19 Guidance and Updates for Nursing Homes during COVID-19, visit here: cms.gov/files/document/covid-guidance-and-updates-nursing-homes-during-covid-19.pdf

The full list of CMS Public Health Actions for Nursing Homes on COVID-19 to date is in the chart below.

CMS Public Health Action for Nursing Homes on COVID-19 as of September 16, 2020

February 6, 2020

CMS took action to prepare the nation’s healthcare facilities for the COVID-19 threat.

March 4, 2020

CMS issued new guidance related to the screening of entrants into nursing homes.

March 10, 2020

CMS issued guidance related to the use of PPE.

March 13, 2020

CMS issued guidance on the restriction of nonessential medical staff and all visitors except in certain limited situations.

March 23, 2020

CMS announced a suspension of routine inspections, and an exclusive focus on immediate jeopardy situations and infection control inspections.

March 30, 2020

CMS announced that hospitals, laboratories, and other entities can perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital – including nursing homes.

April 2, 2020

CMS issued a call to action for nursing homes and state and local governments reinforcing infection control responsibilities and urging leaders to work closely with nursing homes on access to testing and PPE.

April 15, 2020

CMS announced the agency will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases.

April 19, 2020

CMS announced it will require nursing homes to report cases of COVID-19 to all residents and their families, as well as directly to the CDC. On May 1, CMS published the proposed policy in an Interim Final Rule. The rule became effective on May 8.

April 30, 2020

CMS announced the formation of an independent commission by a contractor that will conduct a comprehensive assessment of the nursing home response to COVID-19.

May 6, 2020

CMS released a memorandum to State Survey Agency directors providing more details on the new reporting requirements of the May 8, 2020, Interim Final Rule.

May 13, 2020

CMS published a new informational toolkit comprising recommendations and best practices from a variety of front line health care providers, governors’ COVID-19 task forces, associations and other organizations and experts that is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19. Toolkit is found here: Toolkit

May 18, 2020

CMS issued guidance for state and local officials on the reopening of nursing homes.

June 1, 2020

CMS issued guidance to states on COVID-19 survey activities, CARES Act funding, enhanced enforcement for infection control deficiencies, and quality improvement activities in nursing homes. CMS also issued a letter to Governors.

June 4, 2020

CMS posted the first set of underlying COVID-19 nursing home data and results from targeted inspections conducted by the agency since March 4, 2020, linked on Nursing Home Compare.

June 19, 2020

CMS announced membership of Independent Coronavirus Commission on Safety and Quality in nursing homes

June 23, 2020

CMS released FAQs on nursing home visitation.

June 25, 2020

CMS released a memo announcing the end of the emergency blanket waiver for the nursing home staffing data submission requirement.

July 10, 2020

CMS announced it will deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in hotspot areas.

July 14, 2020

HHS and CMS announced an initiative for rapid point-of-care diagnostic devices and tests in nursing homes.

July 22, 2020

CMS announced several new initiatives designed to protect nursing home residents from COVID-19, including new funding, enhanced testing and additional technical assistance and support.

August 7, 2020

HHS announced the distribution of $5 billion in Provider Relief Funds, consistent with the Administration’s announcement in late July, which will be used to protect residents of nursing homes and long-term care facilities from the impact of COVID-19.

August 14, 2020

CMS released nursing home enforcement actions during pandemic.

August 24, 2020

CMS issues informational bulletin on Medicaid Reimbursement Strategies to Prevent Spread of COVID-19 in Nursing Facilities

August 25, 2020

CMS announced an unprecedented national nursing home training program for frontline nursing home staff and nursing home management.

August 25, 2020

CMS strengthens COVID-19 Surveillance with New Reporting and Testing Requirements for Nursing Homes, Other Providers. On Aug. 26, CMS posted guidance for the new requirements.

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Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS and @CMSgov