Hospital and nursing house leaders did not maintain again of their blunt criticism of CMS’ new necessities round COVID-19 testing and knowledge reporting, characterizing them as overly burdensome.
CMS obtained nearly 170 feedback by yesterday’s deadline on its interim remaining rule, which requires nursing properties to routinely take a look at employees and residents for COVID-19. The rule additionally requires hospitals to report COVID-19 knowledge every day or face dropping their Medicare reimbursement, a penalty the trade mentioned is unnecessarily harsh.
“Threatening our nation’s frontline hospitals and well being techniques with termination of their Medicare participation as a penalty for noncompliance is without delay heavy-handed, pointless, and irrational,” Cathleen Bennett, CEO of the New Jersey Hospital Affiliation, wrote in a Sept. 2 letter. The top of Missouri’s hospital commerce group known as the rule “sudden and jarring.”
A CMS spokesperson wrote in an electronic mail Tuesday that the company appears ahead to a cautious overview of submitted feedback earlier than addressing subsequent steps.
Underneath the rule, which took impact Sept. 2, 2020, hospitals should report their variety of confirmed or suspected COVID-positive sufferers, ICU beds occupied and the provision of provides and gear like ventilators and private protecting gear.
Tom Nickels, govt vp of the highly effective hospital lobbying group the American Hospital Affiliation, urged CMS in an Nov. 2 letter to withdraw the brand new situation of participation clause, amongst different adjustments. Nickels argued that CMS’ motion “erodes and demeans” the worth of its Medicare situations of participation, establishing the “disturbing precedent of counting on CoP-level enforcement to fulfill any demand the company seeks to impose upon hospitals and well being techniques.”
In its personal Nov. 2 letter, the Kids’s Hospital Affiliation known as the termination menace “extreme and pointless,” citing HHS’ personal statistic that present 94% of hospitals are reporting COVID knowledge to the federal authorities.
St. Louis-based Ascension’s Chief Advocacy Officer, Peter Leibold, wrote in an Nov. 2 letter that by making COVID-19 knowledge reporting a situation of taking part in Medicare, CMS is threatening a monetary lifeline for hospitals. Leibold strongly inspired the company to search out an alternate method, arguing the hurt inflicted on hospitals would far exceed that attributable to the violation.
Most of the feedback have been from nursing house operators and the commerce teams that characterize them. The interim rule requires nursing properties in areas with excessive COVID-19 positivity charges to check all of their employees twice weekly. Amenities in areas with barely decrease charges should take a look at as soon as per week, or as soon as a month if the county’s positivity price is lower than 5%.
Amenities that do not comply might face fines of $400 per day or greater than $eight,000 for a case of noncompliance. They is also denied future cost.
The American Well being Care Affiliation—a commerce group that represents greater than 14,000 nursing properties, assisted dwelling amenities and different amenities—wrote in an Oct. 29 letter that it agrees employees testing must be based mostly on the speed of group an infection, however requested the company to rethink its twice weekly take a look at requirement for some areas.
Testing all nursing house workers nationwide for COVID simply as soon as would price an estimated $160 million, and testing all residents would price $130 million, the AHCA estimated. The group famous would not embody oblique prices of testing or different direct prices.
Tammy Pettijohn, the administrator of Sunporch of Smith County, a long-term care facility in rural Kansas, wrote in her remark that her group positivity price is zero% and she or he doesn’t have the employees to tug somebody from their common work to carry out testing on asymptomatic employees.
“That is an unfunded mandate that’s inconceivable to fulfill,” Pettijohn wrote.
CMS mentioned it has helped nursing properties comply by sending out 15,000 fast point-of-care testing units. Whereas Pettijohn wrote that her facility’s machine is an “superior present,” they most likely will not have sufficient provides left to make use of it to check residents after they’ve examined all employees members.
“What a treasured waste and an injustice for the elders we serve in Kansas,” she mentioned.
Different nursing house leaders made related feedback, arguing the testing requirement will additional exacerbate their staffing strains, taking workers away from residents struggling the consequences of isolation.