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AHA urges CMS to reinstate pause in surveys if COVID-19 cases surge

The group is calling for increased flexibility, particularly in the face of a new surge that's taking place in several states.

Jeff Lagasse, Associate Editor

(Photo by westend61/Getty Images)(Photo by westend61/Getty Images)

In a letter sent to the Centers for Medicare and Medicaid Services on Monday, the American Hospital Association said that there should be more suspensions on hospital surveys in the event of a surge in cases of COVID-19.

The previous suspension of on-site hospital surveys began on January 20, and was intended to let healthcare providers focus on their pandemic response during a winter spike in cases. CMS said normal survey activity would resume on March 26, effectively lifting the suspension.


What the AHA is calling for is increased flexibility, particularly in the face of a new coronavirus surge that's taking place in several states.

The issue isn't with the surveys themselves. In the letter, the AHA said they play a "vital role" in ensuring safety and quality care. What the group is advocating for is a nimble approach to hospital surveys, one that takes into account the spikes in cases and hospitalizations that can occur over time.

"While we value the survey process and appreciate the importance of its immediate resumption, we urge CMS to remain flexible in its approach, as additional spikes in cases may require the localized or provider-specific suspensions of surveys," AHA wrote.

To ensure clarity around the process for its members, the group pushed CMS to update its recently released guidance with language that expressly permits additional suspensions, if necessary. AHA offered the example of a new surge in COVID-19 cases in areas of Michigan, which it said may place additional stress on hospitals' and health systems' resources, while also creating an increasingly unsafe work environment for survey staff.

"CMS should, either proactively or by notification from a specific hospital or health system, suspend survey activities for that particular location, allowing providers to focus on responding to the needs of their community with the intention of fulfilling their survey obligations once the surge in cases becomes more manageable," the AHA wrote.


On Jan. 20, CMS issued QSO-21-13-Hospitals, which limited hospital surveys for 30 days to include only immediate-jeopardy complaint allegations suggesting imminent danger to patients at the hospital, or noncompliance with Medicare hospital conditions of participation. It required immediate action to protect patient safety. 

Hospital recertification surveys were suspended, except for a subset of hospital re-accreditation surveys. Hospital enforcement actions for deficiencies that did not represent immediate jeopardy had their termination date extended for at least 30 days. On Feb. 18, CMS extended these hospital survey limitations for an additional 30 days until March 22.

The survey limitations were lifted as of March 23. Providers were allowed to delay the submission of a plan of correction until the survey suspension period ended.

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