CMS Proposes $611,000 Fine of Washington Nursing Home Related to COVID-19 Deaths

CMS Proposes $611,000 Fine of Washington Nursing Home Related to COVID-19 Deaths

The Centers for Medicare & Medicaid Services (CMS) has proposed fining a Washington nursing home $611,000 after a March 16 state and federal inspection of the facility indicated there were serious regulatory infractions that placed residents’ lives in immediate jeopardy.

At least 40 residents in the nursing home have died as a result of the Coronavirus.

The facility was notified of the proposed fine in a recent letter from CMS. The letter indicated that the amount of the fine could be adjusted either up or down dependent upon how the facility corrects the remaining problems. The most serious were noted to be partially corrected in a recent follow-up inspection. The facility can also appeal the fine.

According to federal regulators, the most serious problems involved a failure by the facility to quickly identify and manage residents who became ill during a mid-February outbreak of respiratory illness. The facility also failed to notify the Washington Department of Health about the growing number of respiratory infections among the residents, and the facility failed to have a back-up plan in place when its medical director also fell ill.

On March 18, CMS notified the facility that it had 23 days to remedy conditions that placed residents in immediate jeopardy or be terminated as a Medicare provider; however, in the recent notification, the remedying date was extended to September 16.

The facility’s need to have a medical director in place to coordinate the residents’ care and whether patients’ records are being adequately protected are still CMS’s primary concerns.

Compliance Perspective

Failure to identify an infectious outbreak like COVID-19 that places residents in immediate jeopardy, failure to notify appropriate agencies of the growing number of residents being infected with a respiratory illness, and failure to have a back-up plan in place to assume the responsibilities of the medical director if it becomes necessary, may result in fines and termination as a Medicare provider due to provision of substandard quality of care, in violation of state and federal regulations.

Discussion Points:

  • Review policies and procedures regarding regulations for recognizing and notifying federal authorities about respiratory illness outbreaks like COVID-19. Review policies and procedures for emergency preparedness to determine that a back-up plan is in place should the medical director become incapacitated. Ensure that residents’ medical records are adequately protected during times of emergency.
  • Train staff regarding following CMS and CDC guidelines for responding to and preventing the spread of an infectious respiratory illness like COVID-19, using the facility’s Infection Control Plan, and correcting any deficiencies cited by state and federal inspectors for providing care to the residents.
  • Periodically audit to ensure that cited deficiencies have been corrected and that staff are adhering to Infection Control protocols and following CMS guidelines for preventing the spread of infectious respiratory conditions.

COVID-19 FACILITY PREPAREDNESS SELF-ASSESSMENT