Since early 2020, government oversight of nursing homes was focused on infection disease and its control like the rest of the country. But the federal Centers for Medicare and Medicaid Services recently announced that it instructed state surveyors on addressing complaint backlogs and recertification surveys and to allow visitation for residents at all times.
In a memo to the states, CMS directed state surveyors to continue strong and concerted efforts to resume recertification surveys. Surveys were suspended temporarily in early 2020 to concentrate on infection control related surveys. This created a large backlog and routine inspections resumed in Aug. 2020.
CMS recently took steps to help state surveyors. These included revised standards for conducting infection control surveys, guidance for restarting recertification surveys, and temporary guidance and minor flexibility concerning complaint investigations.
CMS said that it is increasing oversight in nursing homes for a more focused review of quality of life and care concerns. It notified surveyors, for example, to review and pay more attention to nursing home abuse and neglect issues including nursing staff competency, the administration of potentially inappropriate psychotic medication, unplanned weight loss, function or mobility loss, or pressure ulcers.
State agencies will also resume undertaking recertification surveys. However, states do not have to make up for any surveys that could not be completed since March 2020.
State survey agencies must engage in annual focused infection surveys of 20 percent of nursing homes. States should place a priority on these surveys for facilities that are not reporting new infections and have lower infection rates.
These surveys must be stand-alone surveys unrelated to a recertification survey or infection survey. Failure to timely and completely conduct these surveys could lead to the loss of five percent of funding under certain federal programs.
The CMS also notified states that long-term care facilities may not restrict access to surveyors because of their vaccination status or ask them for proof of vaccination status.
CMS is also reviewing guidance for changes that promote broader visitation of residents. Facilities that are too restrictive and forbid visitation under a blanket visitation policy may be considered non-compliant.
Excessive isolation is an unhealthy condition for residents. Previous guidelines on visitation to prevent infections were not intended to be used at all times or in all areas.
Facilities should implement infection mitigation policies. But residents have the right to make their own decisions on their life in the facility. They must be permitted to receive visitors they choose if a visitor, resident, or their representative is aware of the risks related to visitation.
Monitoring should be ongoing. Attorneys can help protect the residents’ rights and seek compensation for neglect or abuse.