Under normal circumstances, state surveyors only visit individual facilities on behalf of CMS about once per year, or perhaps in response to a specific credible complaint. However, new federal guidelines released require all states to perform a “targeted” infection-control survey or risk losing some CARES Act funding, while instituting mandatory follow-up inspections after new outbreaks are reported.
Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma said “At the end of the day, the ultimate responsibility, really, for the health and safety of residents is on the nursing home,” during a phone press conference. “The role of the state and the federal government — we set regulations, we do inspections.”
Verma was answering a question about nursing homes with outbreaks of COVID-19 despite receiving deficiency-free surveys even during the pandemic, a conclusion that questions the integrity and efficacy of the inspections.
“It is simply not plausible, during the pandemic, when at least 32,000 residents have died of COVID-19 and large proportions of deaths from COVID-19 nationwide are residents and staff, that facilities have no problems in their infection prevention and control practices,” the advocacy group said. “Problems cannot be fixed going forward if they aren’t even identified and acknowledged.”
Verma pointed to limitations, however, in the inspection system.
“When you go into the nursing home, the staff know that they’re being observed — particularly on that day. They go in, and they’re looking for things, and they may not see it in that particular visit,” Verma said. “But when the inspector leaves the nursing home, things can change.”
“It just could be at that particular day, [surveyors] didn’t observe anything, and they showed that they had the appropriate policies and procedures in place,” she said. “But when something actually happens — does the staff follow those policies and procedures? May have happened on that particular day, may not happen every day.”