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Nursing Homes Required to Report to CDC and Comply with Federal Family Notification Requirements Starting May 8th

In memorandum QSO-20-26, issued on April 19th, the Centers for Medicare and Medicaid Services (CMS) previewed the requirements for nursing homes to report data related to COVID-19 to the National Healthcare Safety Network (NHSN) at the Centers for Disease Control and Prevention (CDC) and to inform residents and their representatives of COVID-19 cases among residents and staff. Currently, data on suspected or confirmed COVID-19 is reported to state or local health departments, but beginning May 8th, coinciding with the publication of the proposed rule, data will need to be reported to the CDC. According to CMS, the required collection of this information will be used to support surveillance of COVID-19 locally and nationally, monitor trends in infection rates, and inform public health policies and actions. This information may be retained and publicly reported in accordance with law.

The reporting to the CDC will be done through the COVID-19 Module on the NHSN. To be able to access the reporting module, providers first need to be enrolled in the NHSN. The CDC has developed and presented webinars both on enrollment into the NHSN and on the reporting process. While the complete webinars will be posted eventually, the presentation slides are available now: the first containing instructions on how to enroll into the network, the second providing an overview of the reporting module. Members who are not yet enrolled in the NHSN may want to do so quickly to ensure that they have the necessary access prior to the May 8th date when the reporting requirement becomes effective.

The federal family and resident notification requirements are similar, but not identical to State notification requirements. New York currently requires nursing homes (as well as adult care facilities (ACFs)) to notify families of all residents if any resident tests positive for COVID-19, or if any resident suffers a COVID-19-related death, within 24 hours of such positive test result or death. The federal rule goes further by requiring notification of residents and legal representatives, as well as family members. It also requires notification not only of confirmed COVID-19 cases among residents, but also of clusters of residents and/or staff with new-onset respiratory symptoms. The federal rule specifies that notification must be conducted by 5 p.m. the next calendar day following a single confirmed COVID-19 infection or respiratory symptom cluster and that facilities must provide weekly cumulative updates. The notification must include information on actions taken to prevent or reduce the risk of transmission and on alterations in normal operations of the facility. The preamble to the rule indicates that nursing homes may utilize a variety of communication methods to carry out these notifications, including paper notification, listservs, website postings, or recorded telephone messages.

The proposed rule contains the following provisions:

§ 483.80 Infection control.

*         *         *         *         *

(g) COVID-19 reporting. The facility must--

(1) Electronically report information about COVID-19 in a standardized format specified by the Secretary. This report must include but is not limited to—

(i) Suspected and confirmed COVID-19 infections among residents and staff, including residents previously treated for COVID-19;
(ii) Total deaths and COVID-19 deaths among residents and staff;
(iii) Personal protective equipment and hand hygiene supplies in the facility;
(iv) Ventilator capacity and supplies in the facility;
(v) Resident beds and census;
(vi) Access to COVID-19 testing while the resident is in the facility;
(vii) Staffing shortages; and
(viii) Other information specified by the Secretary. 

(2) Provide the information specified in paragraph (g)(1) of this section at a frequency specified by the Secretary, but no less than weekly to the Centers for Disease Control and Prevention’s National Healthcare Safety Network. This information will be posted publicly by CMS to support protecting the health and safety of residents, personnel, and the general public.

(3) Inform residents, their representatives, and families of those residing in facilities by 5 p.m. the next calendar day following the occurrence of either a single confirmed infection of COVID-19, or three or more residents or staff with new-onset of respiratory symptoms occurring within 72 hours of each other. This information must—

(i) Not include personally identifiable information;
(ii) Include information on mitigating actions implemented to prevent or reduce the risk
of transmission, including if normal operations of the facility will be altered; and
(iii) Include any cumulative updates for residents, their representatives, and families at
least weekly or by 5 p.m. the next calendar day following the subsequent occurrence of either:
each time a confirmed infection of COVID-19 is identified, or whenever three or more residents
or staff with new onset of respiratory symptoms occur within 72 hours of each other.

Contact: Elliott Frost, efrost@leadingageny.org, 518-441-8761