The Centers for Disease Control and Prevention’s (CDC) COVID-19 reporting system has improved, but more still needs to be done to ensure safety protocols are promptly in place at nursing homes, a report from the Office of Inspector General (OIG) released Friday states.

The report delved into the intricacies of CDC’s reporting process, specifically focusing on challenges faced by skilled nursing operators during the mass enrollment into the National Healthcare Safety Network (NHSN).

The report recommended that the CDC enhance user support, ensure reporting quality, and consider further enhancements to quality assurance checks. The CDC partially concurred with the first recommendation and fully concurred with the latter two, signaling a commitment to ongoing improvements.

“Continued improvements to NHSN user support and data quality will be important for continued reporting on vaccinations and for future public health surveillance,” OIG’s report noted.

The report also underscores concerns about data quality, with over 25% of nursing homes lacking confidence in the completeness and accuracy of NHSN data. Issues arising from staff turnover affecting data continuity, unclear definitions of data variables, and challenges in reporting COVID-19 vaccination data were prominent themes.

The report found that despite the CDC’s efforts, both the agency and nursing homes experienced obstacles during the mass enrollment into NHSN. The sudden surge in facilities impacted during the pandemic led to a significant backlog of support requests, hindering some from accessing NHSN promptly. Moreover, nursing homes had to grapple with upgrading security access levels to accommodate the reporting of personally identifiable information, contributing to the complexity of the process.

COVID-19 data reporting requirements will continue to be mandatory for operators until December 2024, with vaccination-related data reporting continuing. Researchers said that CDC plans to leverage national enrollment for voluntary reporting on other health events.

Background on the report

In May 2020, CMS mandated nursing homes to report COVID-19 data to NHSN, leading to an unprecedented enrollment of over 12,000 facilities. The CDC, managing NHSN since 2005, faced difficulties during this mass influx, resulting in subsequent challenges for nursing homes in reporting sensitive data.

Researchers said that while challenges persisted, the CDC made significant strides in enhancing the nursing home reporting process throughout the pandemic. Acknowledged by facilities, these efforts were pivotal, yet some continued to face difficulties. Despite CDC’s quality assurance checks on key variables, a quarter of nursing homes expressed a lack of confidence in the quality of NHSN data.

“Stakeholders and CDC expressed that having nursing home participation in NHSN is valuable for public health surveillance, and the agency is exploring opportunities to leverage the current national enrollment for reporting on other health outcomes,” OIG’s report stated.