CMS increases penalties following nearly 26K COVID-19 nursing home deaths

Nursing homes
There have been 60,439 COVID-19 cases amid nursing home residents and 25,923 deaths as of May 24, new Centers for Disease Control and Prevention data found. (Chris Carlson/The Associated Press)

The Trump administration has increased enforcement of states and nursing homes that have been repeat offenders for not following infection control practices.

The new penalties from the Centers for Medicare & Medicaid Services (CMS) come after nursing homes became major hot spots for the spread of COVID-19.

Overall, nearly 26,000 COVID-19 deaths recorded as of May 24 were among nursing home residents, according to new data released by the Centers for Disease Control and Prevention (CDC). Total nursing home resident COVID-19 infections topped 60,000.

“In some states, nursing home deaths may be over 40% of their total deaths,” said CMS Administrator Seema Verma on a call with reporters Monday.

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There were 34,442 nursing home staff cases and 449 deaths, the data also showed.

The agency Monday boosted monetary penalties for nursing homes with persistent violations, and officials said they would reduce federal aid to states that don't fully survey nursing homes. The new actions focus on cutting federal aid to states if they don’t do enough surveys of nursing homes. 

CMS directed states, which inspect and license nursing homes, to focus primarily on infection control back in March as COVID-19 cases ramped up. The CARES Act gave states $80 million to increase their surveys. But states only get that money if they meet certain performance-based metrics.

CMS also said: 

  • States that have not completed 100% of their focused infection control nursing surveys by July 31 will have to submit a corrective action plan to CMS outlining a strategy for completing them within 30 days.
  • If the state has not gotten to all nursing homes during that 30-day period, their federal funding under CARES could be reduced by 10%.

“Subsequent 30-day extensions could result in an additional 5% reduction,” CMS said in a release. “These funds would then be redistributed to those states that completed 100% of their focused infection control surveys by July 31.”

  • States must also perform on-site surveys of nursing homes that previously had a COVID-19 outbreak of three or more new cases.
  • States must perform these surveys within three to five days after the identification of the nursing home cases.

“The idea here is that if they have a positive case or three or more new cases we are requiring the states to go in and do a survey and go back to many nursing home that has an outbreak to do a second,” Verma told reporters.

The agency also said it will increase penalties to nursing homes that have not reported infection control data to the CDC.

It also plans to share the CDC data alongside nursing homes' data on the Nursing Home Compare website. 

The goal is to give the public general information on "how COVID-19 has impacted nursing homes in a user-friendly format," CMS said. "The data will be broken down by state, number of residents and number of staff."

The agency also plans to boost penalties for noncompliance with infection to "prevent backsliding, improve accountability and ensure prompt compliance."