Gandhi A, Yu H, Grabowski DC. Health Aff (Millwood). 2021

Prior research has found that high nursing staff turnover is associated with lower patient safety culture. Starting in July 2016, the Centers for Medicare &  Medicaid Services (CMS) began collecting daily staffing data for US nursing homes and found that nurse turnover rates were correlated with facility location, for-profit status, Medicaid patient census, and star ratings. This information can be leveraged by policymakers, payers, and healthcare consumers and may incentive efforts to reduce nursing staff turnover.

CDC guidance for SARS-CoV-2 infection may be adapted by state and local health departments to respond to rapidly changing local circumstances.

On this page

Visitation

Work restriction for asymptomatic healthcare personnel and quarantine for asymptomatic patients and residents

SARS-CoV-2 Testing

Use of Personal Protective Equipment

Introduction

This guidance applies to all healthcare personnel (HCP) while at work and all patients and residents while they are being cared for in a healthcare setting.

CDC has released public health recommendations for vaccinated persons, which describe circumstances when non-pharmaceutical interventions (e.g., quarantine) could be relaxed for fully vaccinated persons in non-healthcare settings. CDC continues to evaluate the impact of vaccination and the emergence of novel SARS-CoV-2 variants on healthcare infection prevention and control recommendations; updated recommendations will be added to this page regularly as new information becomes available.

Except as noted in Updated Recommendations, HCP should continue to follow all current infection prevention and control recommendations, including those addressing work restrictions, quarantine, testing, and use of personal protective equipment to protect themselves and others from SARS-CoV-2 infection.

Weekly HCP & Resident COVID-19 Vaccination Data Reporting

Long-term care facilities can track weekly COVID-19 vaccination data for residents and healthcare personnel (HCP) through NHSN. This reporting is currently optional.

Medicare Part D Payments During Covered Part A SNF Stay

Medicare Part A prospective payments to skilled nursing facilities (SNFs) cover most services, including drugs and biologicals furnished by the SNF for use in the facility for the care and treatment of beneficiaries. Accordingly, Medicare Part D drug plans should not pay for prescription drugs related to posthospital SNF care because these drugs are already included in the consolidated payment for Part A SNF stays. We will determine whether Medicare Part D paid for drugs that should have been paid under Part A SNF stays.

Background Checks for Nursing Home Employees

Federal regulation 42 CFR 483.12(a)(3) provides beneficiaries who rely on long-term care services with protection from abuse, neglect, and theft by preventing prospective employees with disqualifying offenses from being employed by these care providers and facilities. The National Background Check Program was enacted by legislation in 2010 to assist States in developing and improving systems for conducting Federal and State background checks. Prior OIG work has shown that not all States complied with the National Background Check Program for Long-Term Care Providers. We will determine whether Medicaid beneficiaries in nursing homes in selected States were adequately safeguarded from caregivers with a criminal history of abuse, neglect, exploitation, mistreatment of residents, or misappropriation of resident property, according to Federal requirements. 

Study 1: New findings from a study of thousands of healthcare workers in England show that those who got COVID-19 and produced antibodies against the virus are highly unlikely to become infected again, at least over the several months that the study was conducted. In the rare instances in which someone with acquired immunity for SARS-CoV-2 subsequently tested positive for the virus within a six month period, they never showed any signs of being ill. 

Study 2: Among 156 frontline health care personnel who had positive SARS-CoV-2 antibody test results in spring 2020, 94% experienced a decline in antibodies at repeat testing approximately 60 days later.

Testing Guidelines for Nursing Homes FRIDAY, OCTOBER 16, 2020

Revisions were made on October 16, 2020, to reflect the following:

Updated link to Testing Resources for Nursing Homes one-pager for nursing home personnel with link to Guidance for SARS-CoV-2 Point-of-Care Testing.

Changes to Staffing Information and Quality Measures Posted on the Nursing Home Compare Website and Five Star Quality Rating System due to the COVID-19 Public Health Emergency

Memo #QSO 20-34-NH

Posting Date 2020-06-25

Fiscal Year 2020

Summary

The Centers for Medicare & Medicaid Services (CMS) is committed to transparency about changes in publicly reported information on nursing homes during the COVID-19 public health emergency. Changes to the Nursing Home Compare Website and Five Star Quality Rating System:

• Staffing Measures and Ratings Domain: On July 29, 2020, Staffing measures and star ratings will be held constant, and based on data submitted for Calendar Quarter 4 2019.

o Also, CMS is ending the waiver of the requirement for nursing homes to submit staffing data through the Payroll-Based Journal System. Nursing homes must submit data for Calendar Quarter 2 by August 14, 2020.

• Quality Measures: On July 29, 2020, quality measures based on a data collection period ending December 31, 2019 will be held constant.