Nursing Homes Fined Over $15 Million in Civil Money Penalties Related to COVID-19 Crisis

The Centers for Medicare & Medicaid Services (CMS) recently announced it has imposed over $15 Million in civil money penalties (CMPs) to 3,400-plus nursing homes due to their noncompliance with infection control requirements and failure to report COVID-19 data as required.

The CMS Director issued this statement regarding this aggressive enforcement action: ā€œNow more than ever, nursing homes must be vigilant in adhering to federal guidelines related to infection control to prevent the spread of infectious disease, including COVID-19.ā€ 

CMS and the Centers for Disease Control and Prevention (CDC) developed a nationwide reporting system requiring Medicare and Medicaid certified nursing homes to report COVID-19 cases and deaths directly to the CDC. As of August 3, 2020, over 99 percent of facilities are reporting data. However, for nursing homes that have not reported data or have lapsed in their reporting, CMS is taking enforcement action. Also as of August 3, 2020, CMS has cited more than 3,300 deficiencies and imposed more than $5.5 million in CMPs to nursing homes for failing to report required COVID-19-related data to the CDC.

CMS has issued more than 18 sets of guidance in the last six months to provide states and nursing homes with ongoing information on proper infection control practices and protocols. On June 1, CMS announced increased enforcement for facilities with persistent infection control violations, including enforcement actions on lower level infection control deficiencies to ensure they are addressed with increased gravity. Nursing homes now face fines up to $5,000 when cited for lower level infection control deficiencies that were identified on a previous survey and up to $20,000 if cited for infection control findings twice or more in the last two years.  CMS will continue to take appropriate enforcement actions against facilities that fail to comply with infection control requirements and will use every tool at its disposal to ensure residents are protected during this pandemic.

Compliance Perspective

Failure to comply with CMS and CDC guidelines on proper infection control practices and protocols that results in citations for all levels of infection control deficiencies, including findings identified in previous surveys that occurred two or more times in the prior two years, and failure to report required COVID-19-data may result in CMP fines of up to $20,000.

Discussion Points:

  • Review policies and procedures regarding implementation of CMS and CDC guidelines for infection control and reporting required COVID-19 data.
  • Train staff on CMS and CDC infection control protocols and reporting of required COVID-19 data.
  • Periodically audit to determine if the required data and information regarding COVID-19 cases is being reported to the CDC in a timely and accurate manner.

COVID-19 FACILITY PREPAREDNESS SELF-ASSESSMENT