Grassley Bill Would Require Retroactive COVID-19 Reporting for Nursing Homes, Fund Strike Teams

A trio of Republican U.S. senators, including Senate Finance Committee Chairman Chuck Grassley, introduced a bill this week that would establish regional strike teams to respond to outbreaks in skilled nursing facilities and extend reporting requirements related to COVID-19 — both for the rest of the year and retrospective to the start of 2020.

The Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 was introduced by Sens. Grassley of Iowa, Steve Daines of Montana, and Martha McSally of Arizona.

In addition to the strike teams and reporting mandates, the bill would renew and reauthorize funding for several programs in the Elder Justice Act of 2009.

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Grassley had spoken late last year about his intention to secure a long-term reauthorization of the act, telling Skilled Nursing News at the time that he hoped to have more protections in the legislation.

“Three things: malnutrition, bed sores, and dehydration,” Grassley told SNN. “If you took care of those three things in nursing homes, most people in nursing homes would have a [good] quality of life.”

The bill would include several provisions related to the COVID-19 pandemic, which has hit nursing homes across the U.S. hard due to the vulnerability of an elderly population with high medical needs living in close quarters:

  • Establishing and maintaining a supply of personal protective equipment (PPE) at levels deemed sufficient to protect the safety of the employees of nursing homes, assisted living and personal care facilities, and state survey agencies.
  • Providing COVID-19 testing for 60 days for workers and residents of nursing homes participating in the Medicare and Medicaid programs, as well as for those in assisted living or personal care facilities.

Nursing homes would be required to use “a portion of any payments received or federal relief funds made available on or after July 1, 2020, for responding to the COVID-19 emergency period” to meet those rules, according to the bill summary.

The bill would additionally:

  • Require the secretary of the Department of Health and Human Services (HHS) to ensure that nursing homes participating in Medicare and Medicaid report all cases and fatalities from COVID-19 — from Jan. 1, 2020, to May 8, 2020 — to the Centers for Disease Control and Prevention (CDC). While CMS has required nursing homes to report case and death counts to the federal government, administrator Seema Verma indicated that the agency could not mandate retroactive reporting prior to May under current law.
  • Establish strike teams for states or regions to respond to COVID-19 in SNFs and assisted living, funded by any portion of health-related emergency payments from the federal government are made available under COVID-19 relief legislation enacted on or after July 1.

The bill would also require that the HHS secretary and Office of Inspector General (OIG) compile a list of diagnosis codes that could indicate physical or sexual abuse or neglect of SNF residents, a requirement stemming from a recommendation of the OIG.

It calls for the reevaluation of current protocols around reporting physical injuries indicative of abuse to authorities by state survey agencies.

In addition, the bill would boost resources for the investigation of abuse and neglect and continued funding for certain programs in the Elder Justice Act, as well as upgrading the Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare tool and associated five-star quality rating system.

But in a statement that came with the announcement of the bill, Grassley made it clear that the COVID-19 pandemic is a top priority.

“The first major outbreak of COVID-19 and a significant number of fatalities have occurred in nursing homes,” he said in the release. “This bill will provide resources and ramp up accountability to curb the spread and effects of the pandemic. It’ll also renew several programs already in effect that protect seniors from abuse and neglect. I plan to work toward this bill’s inclusion in any additional coronavirus relief legislation that may be considered.”