Nursing Home Reporting Requirements Will Take Effect May 8

Posted on May 5, 2020 by Jonathan Lips

The Centers for Medicare & Medicaid Services (CMS) on May 1 released an interim final rule containing new nursing home requirements for reporting COVID-19 data. We have prepared a summary of the rule (updated May 5), which directs nursing homes to report information to the Centers for Disease Control & Prevention (CDC) through the National Healthcare Safety Network (NHSN) system and to notify to residents, resident representatives and families of COVID-related information. 

When is the Rule Effective? The requirement will be effective on Friday, May 8, which is the date when the interim final rule is scheduled for publication in the Federal Register. It is possible CMS will allow a short grace period following May 8 for facilities to implement the new requirement, but the agency has not yet indicated that it will do so. For example, CDC data submissions described below must be submitted at least weekly; the LeadingAge national team has asked CMS to identify exactly when that first report will be due, but CMS has not yet provided a response.

Is Assisted Living Covered by this Rule?  No.  The CMS regulatory mandate to report data to the CDC applies only to nursing homes.   It’s a CMS rule change to the skilled/nursing facility requirements of participation.  There has been some understandable confusion about this because CDC staff, in training sessions offered over the past week, have mentioned assisted living repeatedly. But this only means that the CDC reporting module is available for assisted living settings to use if you wish. It does not mean you are required to do it.  CMS does not regulate Minnesota’s housing with services or assisted living settings.  For your settings to be required to report to CDC, the State of Minnesota would have to require it, which has not happened.

Reporting to CDC.  New sections are added to 42 CFR §483.80 Infection Control of the Requirements of Participation for skilled nursing facilities and nursing facilities (ROPs) to require reporting of incidences and data related to COVID-19 through CDC’s National Healthcare Safety Network (NHSN).  The CDC released the long-term care facility COVID-19 reporting module on April 28, consisting of four pathways: Resident Impact and Facility Capacity; Staff and Personnel Impact; Supplies and Personal Protective Equipment; and Ventilator Capacity and Supplies.

To report to the CDC, facilities will need to enroll / register with the NHSN.  The CDC website includes a link to enrollment details, as well as data collection forms and instructions, slides that CDC staff have used for training purposes, and registration links for upcoming, live question-and-answer sessions on May 6, May 7, May 12, and May 14. Space is limited and advance registration is required, so we advise care centers to act quickly in registering for one of these sessions.

Notification to Residents, Resident Representatives, and Families: New sections are added to 42 CFR §483.80 Infection Control of the ROPs to require notification of residents, resident representatives, and families of confirmed or suspected cases of COVID-19 infections among residents and staff.  The rule calls for notifying residents, resident representatives, and families by 5pm the next calendar day following the occurrence of either: (i) a single, confirmed infection of COVID-19 or (ii) a cluster of 3 or more residents or staff with new onset of respiratory symptoms that occur within 72 hours of each other. Additionally, nursing homes must provide cumulative updates on a weekly basis. Information to be shared during notifications and weekly cumulative updates includes mitigating steps the nursing home is taking to prevent or control the spread of COVID-19 and any alterations to normal operations, such as restrictions or limitations to visitation or group activities.

CMS notes that nursing homes are not expected to make individual telephone calls to residents, resident representatives, and families to satisfy these notification requirements. Rather, nursing homes may utilize a number of communication methods including paper notification, listservs, website postings, or recorded telephone messages.

More Information to Follow

We know members have loads of questions about the details of these new requirements.  We are working closely with LeadingAge national to list those questions and seek clarification from CMS, and to develop tools to support you in meeting these new requirements.  What we know about these requirements will likely change on a daily basis, and we will include updates in our nightly member messages in the days ahead.

Please reach out to me by email with any questions along the