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Alabama nursing homes could face fines over COVID-19 data

By CAROLINE BECK, Alabama Daily News

MONTGOMERY, Ala. – Alabama nursing homes will be fined if they don’t start reporting by Sunday cases of COVID-19 and deaths among their residents to a federal database.

Additionally, the state could be penalized if it doesn’t perform in-person infection control surveys at nursing homes with COVID-19 cases by July 31.

The Centers for Medicare and Medicaid Services Administrator Seema Verma said in a press release this week that the increases in penalties are part of “Opening Up America Again” plan.

“The Trump Administration is taking consistent action to protect the vulnerable,” Verma said. “While many nursing homes have performed well and demonstrated that it’s entirely possible to keep nursing homes patients safe, we are outlining new instructions for state survey agencies and enforcement actions for nursing homes that are not following federal safety requirements.”

Since May 1, nursing homes have been required to report COVID-19 cases and deaths directly to the Centers for Disease Control and Prevention.

The CMS doesn’t say how many nursing homes have submitted data to the new database yet but shows as of May 24 there have been 789 COVID-19 cases among residents and 619 cases among staff.  The data also showed 294 nursing home residents and seven staff members have died from COVID-19.

Separately, information released Monday by CMS shows that as of late May, only 23% of Alabama nursing homes have been surveyed by the Alabama Department of Public Health for a required infection control survey.

John Matson, the communications director for the Alabama Nursing Home Association, said some Alabama nursing homes were not able to enroll in the new National Healthcare Safety Network database despite their best efforts.

“This is a reflection of federal systems being overwhelmed and unable to enroll more than 15,000 nursing homes nationwide between the April 24 launch and when first reports were due May 8,” Matson said in a press release.

“The Alabama Nursing Home Association provided (National Healthcare Safety Network) enrollment information and guidance to its members and advised them to begin collecting the data even if the CDC and (National Healthcare Safety Network) were unable to enroll the nursing home before the reporting deadline.”

Matson also told Alabama Daily News that facilities must report data at least once every seven days. Facilities that don’t begin reporting by Sunday will receive a fine of $1,000 for that week, Matson said. If facilities continue not to report data, fines increase.

Matson said that he wishes more emphasis would be placed on patient care instead of paperwork.

“We understand CMS must cite facilities that fail to live up to their responsibilities,” Matson said. “However, more fines and penalties will not solve the problems posed by COVID-19.”

Alabama nursing homes are already required to submit COVID-19 data to their county health office and the ADPH since the pandemic began.

“No other health care provider or business reports COVID-19 cases to more government entities and people than nursing homes,” Matson said.

According to data from the Alabama Department of Public Health, 80% of COVID-19 related deaths in Alabama are people older than 65.

State Health Officer Dr. Scott Harris said last week that ADPH doesn’t release specific data about nursing homes because of privacy concerns.

“We have to be very careful with any type of disease or condition about reporting enough details that would allow someone to be identified in a community or the public,” Harris said. “We very much respect the privacy of people.”

The CMS said they would be releasing a database later this week that would allow the data to be searchable by facility name and will be broken down by state, number of residents and number of staff. The agency will be updating the data weekly.

The CMS also announced this week that states that have not completed a required on-site infection control surveys of nursing homes with COVID-19 cases by later this summer could lose some federal funding.

The CARES Act provided funding to CMS for necessary survey and certification work related to COVID-19, of which $80 million in new resources will be available for states to increase surveys. States that haven’t completed visits to all nursing homes with previous or active COVID-19 cases by July 31 will be required to submit a corrective action plan outlining their strategy for completion of these surveys within 30 days.

If after that time, states have still not performed surveys in 100% of their nursing homes, their CARES Act fiscal year 2021 allocation may be reduced by 10%.  A subsequent 30-day extension could result in an additional 5% reduction.

The Alabama Department of Public Health will conduct the infection control surveys. A spokesperson for ADPH told ADN on Tuesday that it is working to obtain personal protection equipment so its staff can complete the surveys.

“Once necessary PPE is obtained, (ADPH) will make completing infection control surveys in long term care by July 31, 2020, a priority,” Arrol Sheehan, Director of public information for the department, said.

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