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As required by the Centers for Medicare & Medicaid Services (CMS), outlined in QSO-20-29-NH, SNFs/NFs must report certain COVID-19 data to the National Healthcare Safety Network (NHSN) at least once every seven (7) days. Facilities that did not report into the NHSN system by 11:59 p.m. on June 7, 2020 were subject to a per day Civil Money Penalty (CMP) for failure to report that week (the week of June 7), and for each subsequent week that data is not reported the CMP will increase by $500. The facility will also be cited for F884 at scope and severity level F, though no plan of correction is required.
Even with the issues that facilities have had registering for and reporting to NHSN, CMS has begun sending CMP letters to nursing facilities that do not have data in the NHSN system. IHCA/INCAL and AHCA have pushed back on CMS (see later in this article for CMS responses).
CMP letters are being reported through the CASPER/QIES system. You should check your CASPER/QIES portal to check for a letter as the fines and appeal rights are stated within that letter. Federal Independent Informal Dispute Resolution to question cited deficiencies is available as is a formal challenge and appeal of the CMS through the HHS Departmental Appeals Board. Appeals must be filed 60 days from date of the CMS letter.
To assist facilities with compliance and to avoid CMPs and points on the nursing home compare rating, we recommend the following:
Contact information for Kara Dawson:
Feel free to also contact Lori Davenport at firstname.lastname@example.org
IHCA and AHCA have reported these difficulties to CMS and have engaged CMS to reverse these decisions given the system difficulties. AHCA has head back today from CMS on several issues and a few more are pending.
CMS Response: CMS has said providers should follow the IIDR process specified in the enforcement letter and that CMS will consider adequate evidence of providers trying to register and submit data when reviewing IIDR submissions as long as facilities have documentation that shows they did not wait to the last minute to register and that CDC/NHSN has been slow to respond or their recommendations were ineffective, or that the required data was submitted timely. CMS has said they are looking into a more “streamlined” IIDR process for reviewing these citations.
CMS response: They are using the CASPER system because this allows them to automate the process for issuing these 2567s and enforcement letters on a weekly basis. They are looking at additional options to alert the facility when the notice has been uploaded into CASPER.
CMS response is pending.
CMS response is pending.
CMS response: Facilities need to follow the IIDR instructions and that will be taken into consideration during the IIDR review.