Verma: Nursing Home COVID-19 Surveys Currently Focused on California, New York, Seattle Area

The federal government’s emergency coronavirus survey apparatus for nursing homes is slowly coming to life, with a current focus on those areas hardest hit by COVID-19.

The Centers for Medicare & Medicaid Services (CMS) on March 4 took the early step of refocusing all nursing home inspections on infection control and reported cases of the coronavirus, while also indefinitely suspending all non-emergency surveys.

“The surveyors have already been in action,” CMS administrator Seema Verma said on a press call late Tuesday. “I can tell you that we’re focused right now on some of the hotspots — that’s in the Seattle area, California, and New York.”

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The Seattle metropolitan area has been an epicenter of the coronavirus crisis in the United States, with a deadly outbreak at a Life Care Centers of America-operated nursing home in the suburb of Kirkland, Wash. serving as one of the earliest warning signs of the coronavirus’s deadly potential.

Seven counties in the San Francisco Bay Area have issued sweeping shelter-in-place orders closing most non-essential businesses, and New York Gov. Andrew Cuomo on Tuesday indicated that the rise in Empire State cases may not peak for another 45 days.

CMS has also heard increasing reports of COVID-19 cases in New York State nursing facilities, Verma said Tuesday evening.

Though word of CMS’s triaged survey strategy came down much earlier than the other restrictions the industry and the general public have seen this month — from a strict ban on non-essential visits to nursing homes and widespread social distancing protocols — implementing the plan still took time, Verma said Tuesday.

“It also took us a few days to make sure that our surveyors have the appropriate equipment, the protective equipment before they go into these facilities as well,” Verma said.

Surveyors are still considered essential visitors under current CMS rules, though they must be screened for symptoms of the virus and wear protective equipment before entering facilities.

Some confusion still remains over which kinds of health care professionals count as essential under the blanket restrictions, with the American Health Care Association affirming earlier this week that therapy services should continue — but there have been anecdotal reports of individual buildings turning away occupational, physical, and speech therapists over COVID concerns.

Verma acknowledged that lack of clarity Tuesday.

“We are getting a lot of questions from nursing homes, and we’re putting together some calls with the nursing homes to provide more guidance,” the administrator said.

In particular, CMS officials are advising operators to suspend all non-emergency maintenance work, though outside contractors can and should still enter the building for pressing issues such as broken refrigerators or heating and cooling equipment. As with all other visitors, these vital workers should be screened for signs of infection and furnished with the appropriate protective equipment.

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