November 16, 2021
In this Issue:
- Updated Nursing Home Visitation Guidance from CMS; Consumer Voice Webinar Thursday
- CMS Updates Guidance Related to State Survey Processes
- CMS Releases Latest List of Special Focus Facilities and Candidates
- November is National Family Caregiver Month
Updated Nursing Home Visitation Guidance from CMS; Consumer Voice Webinar Thursday
On November 12, the Centers for Medicare & Medicaid Services (CMS) updated their Nursing Home Visitation Guidance. After a year and a half of residents and their loved ones being separated from each other and subject to confusing and often ignored visitation guidance, visitation is now allowed at all times for all residents, this includes indoor visitation. All visitors must continue to adhere to infection prevention practices.
Additional Key Points, include:
- Facilities can no longer limit frequency and length of visits, number of visitors, or require advanced scheduling of visits.
- Vaccinated and unvaccinated residents can have close contact, including touch. Visitors should be advised of the risks of physical contact with unvaccinated residents before the visit.
- Communal activities and dining may occur while adhering to core principles of COVID-19 infection prevention. The safest approach is for everyone, regardless of vaccination status to wear a mask while in communal areas.
On Thursday, November 18th at 3pm ET, Consumer Voice will be holding a webinar explaining the new visitation guidance. Register Now >>
CMS Updates Guidance Related to State Survey Processes
On November 12, 2021, the Center for Medicare & Medicaid Services (CMS) issued updated guidance related to state survey processes. The guidance relaxes requirements regarding infection control surveys, clarifies timing on annual recertification surveys, addresses the complaint backlog, and announces increased survey scrutiny in particular areas of care quality. See a brief summary of the guidance below and read an extended summary on our website.
Infection Control Surveys - The updated guidance rescinds the previous requirements that State Survey Agencies (SAs) perform focused infection control surveys within 3-5 days in nursing homes with new COVID-19 cases. SAs will still be required to conduct focused infection control surveys of 20% of nursing homes in the state, focusing on facilities with new cases or low vaccination rates.
Recertification Surveys – The updated guidance states all recertification surveys must resume. CMS also recommends that SAs prioritize facilities with histories of noncompliance or allegations of noncompliance in the areas of abuse and neglect, infection control, violations of transfer or discharge requirements, insufficient staffing or competency, Special Focus Facilities (SFF) and (SFF) candidates, and other quality of care issues.
Complaint Back Log - As a result of the COVID-19 pandemic and CMS limiting survey activity to only complaints alleging Immediate Jeopardy (IJ), many SAs have a significant complaint backlog. To address this issue, the new guidance allows SAs to address some complaints during recertification surveys. The guidance states that SAs must investigate all IJ complaints/FRIs within two days and Non-IJ High complaints/FRIs within ten days. CMS provides further guidance to SAs for investigating Non-IJ Medium Complaints/Facility Reported Incidents (FRIs) and Non-IJ Low Complaints/FRIs.
Increased Oversight - CMS also stated it is increasing oversight of nursing homes and focusing particularly on several areas: Nurse/Certified Nursing Assistant Competency; Inappropriate Use of Antipsychotic Medications; and Identifying Other Areas of Concern.
CMS Releases Latest List of Special Focus Facilities and Candidates
The Centers for Medicare & Medicaid Services (CMS) has released the latest list of Special Focus Facilities (SFF) and candidates (October 27, 2021). CMS oversees the SFF program, which places special scrutiny on select nursing homes with a documented pattern of providing poor care. CMS publicly discloses the names of the facilities chosen to participate in this program and candidate nursing homes. To be considered for the SFF program, a facility must have a history (at least 3 years) of serious quality issues. These nursing facilities generally have more deficiencies than the average facility, and more serious problems such as harm or injury to residents. Special Focus Facilities have more frequent surveys and are subject to progressive enforcement until it either graduates from the program or is terminated from Medicare and/or Medicaid.
The recent release from CMS is broken into several lists: Facilities Newly Added to the SFF Program (9 facilities); Facilities that Have Not Improved (13 facilities); Facilities that Have Shown Improvement (43 Facilities); Facilities that Have Recently Graduated from the SFF Program (15 facilities); Facilities No Longer Participating in the Medicare and Medicaid Program (1 facility); and the SFF Candidate List (440 facilities).
What can advocates do with this information?
- Include the list of facilities in your area/state when providing information to consumers who are looking for a nursing home. Include an explanation of the SFF program and the candidate list.
- Post the list on your program’s/organization’s website (along with the explanation noted above).
- Encourage current residents and families to check the list to see if their facility is included.
- Urge residents and families in a candidate facility to ask the administrator what is being done to improve care.
- Suggest that resident and family councils invite the administrator to a council meeting to talk about what the facility is doing to improve care, ask for ongoing updates, and share any council concerns.
- For ombudsmen: Meet with the administrator to discuss what the facility is doing to address problems and share any resources that might be helpful.
November is National Family Caregiver Month
November is National Family Caregiver Month, a time to recognize and honor family caregivers and an opportunity to raise awareness of caregiving issues, educate communities, and increase support for caregivers.
Consumer Voice has several resources available for family caregivers including:
Find resources from other organizations: