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CMS Proposes to Extend Nursing Home NHSN Reporting

(July 2, 2024) The proposed Medicare Home Health Payment Rule, scheduled for publication in the Federal Register on July 3rd, holds an unwelcome surprise for nursing home providers. In it, the Centers for Medicare and Medicaid Services (CMS) not only proposes to make some of the current federal COVID-19 reporting permanent, but it also seeks to pave the way for expanding mandatory reporting that nursing homes do to the National Healthcare Safety Network (NHSN).

In the proposed rule, CMS would extend NHSN reporting requirements (some of which are scheduled to sunset at the end of 2024) indefinitely, making them part of the Requirements of Participation with which all CMS-certified nursing homes must comply. Additionally, the agency would expand the list of required elements to include data on influenza and respiratory syncytial virus (RSV). If adopted as proposed, starting in 2025, NHSN reporting for nursing homes would be expanded to include:

  • resident vaccination status for respiratory illnesses including COVID-19, influenza, and RSV (and perhaps more);
  • detailed breakdowns by vaccination status of confirmed resident cases of respiratory illness including COVID-19, influenza, and RSV (and perhaps more); and
  • hospitalized residents with confirmed respiratory illness broken down by COVID-19, influenza, and RSV, and reported as overall numbers along with breakdowns by vaccination status.

Finally, the rule would also allow CMS to require additional reporting in the future without following the typical stakeholder input process should it be determined that a public health emergency due to an acute respiratory illness is occurring, or that there exists a significant threat of an occurrence. While the idea of data on the health and immunization status of nursing home residents may be appealing, it is accompanied by the risk of citations and penalties, and in many cases, such as in NY, may be duplicative and/or inconsistent with data collected by state-level efforts.

Nursing home members interested in submitting comments directly to CMS should do so by Aug. 26, 2024. The link to the public inspection version (i.e., pre-publication version) of the proposed home care payment rule is here. The nursing home reporting provisions are outlined on pages 185-204. Instructions for submitting comments are provided at the beginning of the document.

Members not commenting directly but interested in their thoughts being reflected in the comments submitted by the association are asked to share their comments with us by Aug. 19th. A summary of the home health provisions of the proposed rule is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841