Lawmakers Call on OIG to Investigate State Orders on Nursing Home Admissions of COVID-19 Patients

A pair of Republican lawmakers called on the Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG) to investigate five states that ordered nursing homes to take in COVID-19 patients from the hospital.

A pair of Republican lawmakers called on the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) to investigate five states that ordered nursing homes to take in COVID-19 patients from the hospital.

NPR first reported the news on Monday.

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In a June 29 letter to OIG’s principal deputy inspector general, Sen. Chuck Grassley, R-Iowa, and Rep. Greg Walden, R-Ore., called for an inspection on whether the policies of New York, New Jersey, California Pennsylvania and Michigan on COVID-19 patient discharges violated guidelines or requirements for participation in federal health care programs.

Walden is the ranking member of the House Energy and Commerce Committee, while Grassley is chairman of the Senate Committee on Finance.

While acknowledging that infection control remains an issue at many skilled nursing facilities, that SNF residents are uniquely vulnerable to COVID-19 and that staffing has been a challenge well before the pandemic, Grassley and Walden highlighted the policies of the governors – all Democrats – of the five states in question.

“These state directives were issued as the COVID-19 fatality rate in nursing homes soared,” Grassley and Walden wrote.

They also specifically singled out New York Gov. Andrew Cuomo for reportedly reinforcing the requirement that nursing homes take in COVID-19 patients even after the time period when COVID-19 cases in acute care peaked, “suggesting that its imposition on nursing homes was not entirely due to hospital overcrowding,” they wrote.

New York rescinded the rule on COVID-19 admissions to the SNF setting from the hospital in May.

Grassley and Walden both acknowledged that some nursing homes with otherwise checkered histories of care might be incentivized financially to take in COVID-19 patients, which made it all the more paramount that other options for such patients exist, they argued.

“In light of this incentive, public officials should have expressly, and consistently, encouraged nursing home facilities uncomfortable with their directive to make alternative arrangements for those infected with the virus,” the lawmakers wrote.

They also pointed to guidance from the Centers for Medicare & Medicaid Services listing two factors when deciding whether to send a COVID-19 patient to a long-term care facility: the patient’s medical readiness, and the long-term care facility’s ability to safely care for such a patient.

Additionally, Grassley and Walden highlighted other strategies, such as banning hospitals from discharging infected patients into SNFs and establishing facilities specifically for COVID-19 patients.

The OIG will be able to “fairly analyze governors’ decisions on nursing homes with the given information, as well as the governors’ decision to ignore guidance from the federal government,” a Republican aide to the Energy and Commerce Committee told SNN via email.

“As we do not know yet whether a second wave of the COVID-19 will occur later this year, we ask that you present your initial findings by September 30, 2020,” Grassley and Walden wrote.

Robert Redfield, the director of the Centers for Disease Control and Prevention (CDC), was copied on the letter.

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