Will Feds Relax Infection Control Nursing Home Rules?

The federal government is moving forward with regulations that would relax infection control requirements in nursing homes even while the coronavirus pandemic has overwhelmed long-term care facilities throughout the nation.  At the same time, most federal nursing home inspections are being suspended.

The Centers for Medicare and Medicaid Services (CMS) proposed new rules in July 2019 that would remove the requirement that nursing homes have a part-time infection preventionist on staff. Instead, the rules would require facilities only to ensure that the infection preventionist has “sufficient time” at the facility. While the proposal was made before the coronavirus pandemic, USA Today reports that CMS recently defended its proposal as reducing regulatory burden. 

Infection is always a serious problem in nursing homes and the coronavirus pandemic has highlighted the issue. According to data analyzed by USA Today, more than 16,000 long-term-care residents and staff have died of COVID-19 and nearly 97,000 residents and staff have tested positive for the virus. This is likely an undercount because not all states have released data, and testing has been limited. 

CMS has defended the rule by arguing that it would allow facilities more flexibility, including having an infection preventionist on site full-time, if needed. However, elder care advocates disagree with the rule. "It makes no sense at all – prior to pandemic, but more so now during a pandemic – to roll back any of the necessary infection and control requirements and the federal regulations," Lindsay Heckler, a supervising attorney at the Center for Elder Law & Justice, a civil legal services agency in Buffalo, New York, told USA Today. "They should be strengthening these infection and control requirements."

Meanwhile, Bloomberg Law reports that CMS has halted most on-site, non-emergency nursing home inspections during the COVID-19 pandemic.  Facilities are being advised to conduct their own inspections. 

“There’s literally no set of eyes on the ground in most of these places,” Michael Dark, staff attorney with California Advocates for Nursing Home Reform, told Bloomberg. “And until they actually start suiting up and sending inspectors into these facilities, to check on things like understaffing and infection control, what’s already a horrible situation is going to get much worse.”