To: Mass Senior Care Members
From: Tara Gregorio, President
RE: CMS: Prioritization of Survey Activities
Date: March 24, 2020
On March 23, CMS released guidance prioritizing and suspending most federal and state survey agency (SSA) surveys, and delaying revisit surveys, for the next three weeks beginning on March 20, 2020, for all nursing homes. For non-IJ related onsite surveys that are currently in process, survey teams are instructed to end the survey and exit the facility.
State and federal surveyors should not enter the building, for any type of survey, if they are unable to meet the Personal Protective Equipment (PPE) expectations outlined by the latest CDC guidance. They may instead obtain necessary information remotely, to the extent possible.
Federal and state surveyors will conduct targeted infection control surveys of providers identified together with the Centers for Disease Control and Prevention (CDC) and the HHS Assistant Secretary for Preparedness and Response (ASPR). They will use this survey tool to review infection prevention and control practices.
Changes in the survey process in effect for the next three weeks include:
Standard surveys and non-IJ revisits are suspended for three weeks including:
- Standard surveys and non-IJ revisits
- Life safety code and emergency preparedness elements of standard surveys.
- Revisits not associated with an IJ.
The following enforcement actions will be suspended, until revisits are again authorized:
- Imposition of Denial of Payment for New Admissions (DPNA), including situations where facilities are not in substantial compliance at 3 months.
- Imposition of termination for facilities that are not in substantial compliance at 6 months.
- Per day civil money penalties (CMP) will not accumulate.
- CMS will not impose any new remedies for prior noncompliance.
Note: Enforcement actions for unremoved or new IJs remain and will continue to be issued under normal procedures/guidance.
Complaints and facility-reported incidents triaged at the Immediate Jeopardy level will continue.
- State survey agencies (SSAs) and CMS will only conduct surveys related to complaints and facility-reported incidents (FRIs) that are triaged at the Immediate Jeopardy (IJ) level, and revisits to verify removal of IJ (including previously cited IJ deficiencies).
- If the revisit survey determines there is continuing noncompliance, but at a lower level than IJ, surveyors will not conduct another onsite revisit survey.
- For non-IJ deficiencies, providers may submit a plan of correction (POC) to be held until the end of the three-week period or may delay submission of their POC until the end of this period.
- Enforcement actions for unremoved or new IJs remain and will continue to be issued under normal procedures/guidance.
Nursing homes should use the COVID-19 Infection Control Focused Survey Tool to perform self-assessments of your facility’s Infection Control plan. This document may be requested by surveyors, if an onsite investigation takes place.