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CMS relaxes hospital, nursing home inspections

On-site inspections will continue at certain facilities, such as the Life Care Center in Kirkland, Washington, where 26 residents died.

Susan Morse, Managing Editor

The Centers for Medicare and Medicaid Services has relaxed healthcare facility inspections during the coronavirus pandemic and is allowing hospitals and nursing homes to do a voluntary self-assessment to assure they are meeting federal requirements.

Today's announcement follows a Joint Commission decision that, starting on March 16, it would suspend regular accreditation and certification surveys.

CMS surveyors are using revised inspection protocols for hospitals and nursing homes. The agency is reprioritizing surveys to focus on infection control for facilities that have had an infection-control deficiency in the past to assure that they are in compliance with the new regulations.

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On-site inspections will continue at facilities that have been found not to be in compliance, such as the Life Care Center Kirkland, Washington, where 81 residents became infected with the coronavirus and 26 died.

Kirkland "was ground zero," CMS Administrator Seema Verma said today, as it was the first area in the country to report a concentration of cases.

"We cited the facility for immediate jeopardy," Verma said.

The nursing home failed to identify and manage sick residents, failed to notify the state department and failed to have a back-up plan for when the staff doctor became sick, according to Verma.

An additional unannounced inspection is expected there and the facility could face monetary penalties should it not meet required standards. The nursing home has not been cleared at this point, Verma said.

Public health service clinicians deployed there will soon be needed elsewhere, she said. At least 146 nursing homes in more than 20 states have coronavirus cases among their residents.

Usually, the 15,000 nursing homes in the nation are inspected, or surveyed, at least once a year.


Providers have no time to prepare for inspection and through its waiver authority, CMS can suspend routine surveys, Verma said today.

One issue for nursing homes is that of admitting patients from hospitals without an assurance that the individual is not infected with COVID-19. Due to a scarcity of tests, nursing homes are challenged in meeting CMS guidelines to assure that its residents are not sick.


Today's announcement follows another this weekend that CMS was relaxing regulatory reporting requirement for such programs as MIPS and Medicare Shared Savings.

CMS is also relaxing some Medicaid requirements for states that apply for Section 1135 waivers. Washington and Florida have gotten the waivers for Medicaid that offer flexibilities such as waiving prior authorization requirements.

CMS has created four checklists to make it easier for states to receive federal waivers and implement flexibilities in their program. The four tools permit states to access emergency administrative relief, make temporary modifications to Medicaid eligibility and benefit requirements, relax rules to ensure that individuals with disabilities and the elderly can be served in their homes, and modify payment rules to support healthcare providers impacted by the outbreak.

Twitter: @SusanJMorse
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