CMS Touts $15M in Nursing Home Fines Amid COVID-19 as Infection Citations Triple

The federal government on Friday announced that it has handed out $15 million in civil monetary penalties (CMPs) to about 3,400 nursing homes during the COVID-19 pandemic.

That total includes about $10 million in fines stemming from targeted infection control surveys, and $5.5 million assessed to operators that failed to report COVID-19 data as required by the Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control & Prevention (CDC).

“Now more than ever, nursing homes must be vigilant in adhering to federal guidelines related to infection control to prevent the spread of infectious disease, including COVID-19,” CMS administrator Seema Verma said in a statement. “We will continue to hold nursing homes accountable and work with state and local leaders to protect the vulnerable population residing in America’s nursing homes.”

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CMS reoriented its inspection efforts around infection control early in the pandemic, and eventually required State Survey Agencies to perform targeted infection-control surveys at all of the nation’s more than 15,000 facilities.

With that task 99.2% complete, inspectors found 180 infection control violations at the highest “immediate jeopardy” level, or three times higher than the rate logged in 2019. The average CMP amount totaled $55,000.

On the data front, CMS handed down 3,300 citations for failure to submit the required information about COVID-19 cases and deaths, though the agency acknowledged that “the majority of nursing homes are reporting data as required.”

The news came a day after Verma said the agency was “deeply concerned” about rising COVID-19 case counts in nursing homes across the country, and pointed a finger at facility-level infection control lapses as a driver of the trend.

“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,” Verma said on a Thursday conference call with nursing home leaders and other CMS officials.

The Trump administration has faced criticism over its handling of the COVID-19 crisis in nursing homes, with the non-profit Center for Medicare Advocacy claiming the relatively low levels of citations reported in earlier summaries of coronavirus survey data was “simply not plausible” given the number of infections and deaths.

CMS did boost fines for nursing homes with a history of infection-control violations, an exceedingly common type of citation even in the pre-pandemic era.

Industry leaders, backed by some academic researchers, have argued that fines could do more harm than good during the immediate crisis, given the financial strains placed on operators as the cost of personal protective equipment (PPE) and labor has skyrocketed.

“I think these policies are at best premature, and at worst, probably a little dangerous,” R. Tamara Konetzka, a professor of health services research in the Department of Public Health Sciences at the University of Chicago, told SNN back in June. “Most of the research that’s been done on quality and the probability of a nursing home having a COVID outbreak, or COVID-related deaths, has shown that there’s actually not much of a relationship with quality.”

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