CMS Targets Infection Control in New Nursing Home Training Program

A few weeks after the nation’s top Medicare official pointed to persistent infection control problems as a major driver of rising COVID-19 cases in nursing homes, the Centers for Medicare & Medicaid Services (CMS) on Tuesday introduced new online training resources for frontline staffers and management.

Officials based the new “CMS Targeted COVID-19 Training for Frontline Nursing Home Staff and Management” on lessons from the field — including the results of targeted infection control inspections, input from Centers for Disease Control & Prevention (CDC) epidemiologists, and the work of nursing home “strike teams” deployed to hotspots.

“The strike teams learned that while current regulations were designed to protect the health and safety of residents, the pandemic created an urgent need to directly assist frontline workers with more focused training and guidance than has been used in the past,” CMS observed in announcing the resources.

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The programs — available through CMS’s Quality, Safety, and Education Portal — include modules on such basic infection-control steps as hand-washing and cleaning, as well as more complex topics such as safe cohorting, handling admissions and transfers, and preparing for the distribution of an eventual COVID-19 vaccine.

“CMS is taking unprecedented action to ensure that nursing homes are doubling down on efforts to prevent the spread of the virus,” CMS administrator Seema Verma said in a statement. “This national training program is just the latest example of our coordinated and aggressive response to this unprecedented situation.” 

Seemingly simple practices such as hand hygiene, widespread availability of alcohol-based hand sanitizers, and appropriate use of personal protective equipment (PPE) have remained persistent problems for nursing homes during the pandemic, CMS officials observed earlier this month.

“What we are seeing are significant deficiencies in infection control practices,” Verma said on August 13. “A lot of your management seems to be very attuned to the requirements and the guidelines. These are long-standing guidelines that we’ve had in place. Unfortunately, what we’re seeing on the ground is that some of the translation to frontline staff — sometimes that there are issues there.”

Verma also emphasized that the issues were present even in facilities that were able to overcome struggles with access to testing and sufficient supplies of PPE.

“This is not just a testing issue or a supply issue, and our deep concern is that even in nursing homes that are doing testing on a regular basis, that we are still seeing significant spread — and so even with our commitment to do more testing, to ensure you have the supplies that you need, our concern is that that’s not going to necessarily completely address the problem,” she said.

The CMS network of Quality Improvement Organizations (QIOs) will use the new training materials as part of the “action plans” it develops with certain nursing homes, according to the agency.

“This will help ensure that nursing homes are building the training into their existing quality improvement efforts,” CMS noted.

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