CMS Finds PPE Compliance Issues at Nursing Homes in First Round of COVID-19 Surveys

Buried in an early April announcement from the federal government about updated COVID-19 guidance for nursing homes, the Centers for Medicare & Medicaid Services (CMS) released a pair of statistics from the early days of an infection-control crackdown by state inspectors.

Surveyors found that 36% of facilities were not following proper hand-washing protocols during the week of March 30, while 25% did not demonstrate proper use of personal protective equipment (PPE), CMS announced last week.

“Both of these are long-standing infection-control measures that all nursing homes are expected to follow per federal regulation,” CMS warned. “CMS is continuing to conduct targeted infection control inspections to ensure nursing homes are prepared to confront COVID-19 and keep their residents safe.”


Those figures represented the first public glimpse into the status of CMS’s earliest move to fight the coronavirus, a March 4 decision to suspend all non-emergency surveys in order to focus primarily on compliance with infection control standards.

They were also set against widespread stories of PPE shortages in markets across the country, a growing problem as the number of cases in nursing homes continues to rise — and CMS enforces the expanded use of masks and gowns in the post-acute and long-term care setting.

But CMS’s guidance on the issue, at least for now, continues to absolve operators from citations if they are unable to secure a sufficient supply due to reasons beyond their control.


“However, we do expect facilities to take actions to mitigate any resource shortages and show they are taking all appropriate steps to obtain the necessary supplies as soon as possible,” CMS noted in a March 13 memo that serves as the basis of federal and state inspection efforts.

As such, any citations for PPE-related violations in the first round — and onward — center around cases where facilities had sufficient volumes of PPE, but inspectors observed improper use of masks and gowns.

Compliance with these guidelines will continue to be vital for nursing homes as the COVID-19 crisis rages on, both to protect residents and prevent compliance issues with CMS and state governments. In addition to the March 4 announcement, CMS late last month rolled out a self-assessment tool and other stricter guidelines directly inspired by the deaths at a nursing facility in Kirkland, Wash.

The $2 trillion coronavirus stimulus package passed last month contained $200 million for CMS’s infection-control efforts, and states have additionally taken their own actions to enforce protocols amid the spread of COVID-19: Georgia, for instance, has deployed members of the National Guard to help facilities implement new procedures and disinfect surfaces.

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