States haven't inspected nearly half of nursing homes to make sure they're meeting federal infection control standards, CMS said Monday.
While Colorado, Nevada, North Dakota and Wyoming have surveyed all nursing homes in their borders, other states haven't inspected the vast majority of them, according to new data collected by the Centers for Disease Control and Prevention. West Virginia has only investigated 11.4% of its nursing homes, and many states haven't fared much better.
CMS is threatening to strip those states of their Coronavirus Aid, Relief and Economic Security Act funding for inspections if they don't complete all their surveys by July 31. States that miss the deadline will have to submit a corrective action plan describing how they'll complete the surveys within 30 days. They could lose 10% of the CARES Act funds if they don't inspect nursing homes by that extension.
States could lose another 5% of their inspection funding for each additional month they fail to comply with the inspection standard.
Any funds stripped from one state for failing to complete inspections will be funneled to other states that met the July 31 requirement, CMS said.
The Trump administration will also increase fines against nursing homes that have continuously violated long-standing infection control practices, and roll out stricter enforcement of "lower-level infection control deficiencies," the agency said in a statement.
"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," CMS Administrator Seema Verma said in a statement.
The Trump administration has leaned heavily on states in response to the COVID-19 pandemic, emphasizing that its approach is "locally executed, state-managed and federally supported." Supporters say it's the right approach because state officials are closer to the situation on the ground and understand it better than bureaucrats in Washington. But critics say that the federal government is ducking its responsibilities and hiding behind the veil of federalism, leaving states to fend for themselves despite their lack of resources and expertise.
According to CMS, nursing homes reported more than 60,000 confirmed COVID-19 cases and nearly 26,000 deaths to the CDC. About 80% of Medicare and Medicaid nursing homes reported the newly required information.
"Of the nursing homes that reported data, approximately one in four facilities had at least one COVID-19 case, and approximately one in five facilities had at least one COVID-19 related death," CMS said in a statement.
Facilities that had a one-star quality rating were more likely to have large numbers of COVID-19 cases than facilities with a five-star quality rating, the agency said.
The federal government doesn't know whether the data includes all cases and deaths from nursing homes since new federal regulations only require that facilities report data starting May 8, Verma said during a press call. But she's confident that most nursing homes reported all cases and deaths because the figures line up with independent reports. Verma noted that most of the differences in the reported numbers could probably be attributed to the fact that the CDC data doesn't include information from assisted living facilities, unlike other data sources.
Under the CARES Act, Congress gave CMS $80 million to give to states to spend on nursing home inspections and related activities.