Health Law Daily Surveys coming back for care facilities and labs after COVID-19 slow down
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Tuesday, August 18, 2020

Surveys coming back for care facilities and labs after COVID-19 slow down

By Cathleen Calhoun, J.D.

CMS is revising guidance on the expansion of survey activities to authorize onsite revisits and other survey types.

CMS has revised its guidance on survey activities to release suspension of enforcement actions, allow more surveys, and re-prioritize routine state survey agency (SA) Clinical Laboratory Improvement Amendments (CLIA) survey activities. Because of the COVID-19 public health emergency declaration in March, CMS limited surveys to focused infection control surveys, investigation of complaints and facility reported incidents alleging immediate jeopardy (IJ) to patient/resident health and safety, and revisit surveys necessary to verify removal of previously identified IJ deficiencies. CMS also suspended all enforcement actions that were pending as of March 23, 2020, since revisit surveys were not possible (CMS Letter, QSO-20-35-ALL, August 17, 2020).

Long-term care. According to CMS, states should resume performing the following surveys for long-term care facilities as soon as they have the resources, such as adequate staff and personal protective equipment, to do so:

  • Onsite revisits as specified in the revisit policy in the State Operations Manual (SOM), Chapter 7, Section 7317.2, for surveys with end dates on, or after, June 1, 2020;
  • Complaint investigations that are triaged as Non-Immediate Jeopardy Medium; and
  • Annual recertification surveys required to be conducted within 15 months from a provider’s last recertification survey.

CMS will resolve enforcement cases that were suspended. The resolution process involves four components: (1) expanding the Desk Review policy for Plans of Corrections (POCs); (2) processing enforcement cases that were started before March 23, 2020; (3) processing enforcement cases that were started on March 23, 2020, through May 31, 2020; and (4) processing enforcement cases that were started on or after June 1, 2020. Examples are included in the guidance.

Non-long-term care. CMS advises that once states have entered into Phase 3 of reopening, or earlier if at a state’s discretion, states should resume normal survey activities according to guidance in the FY 2020 Mission & Priority Document. However, states should prioritize their survey backlog as follows (descending in priority):

  1. Revisit surveys for past non-compliance that do not otherwise qualify for a desk review;
  2. Complaint surveys triaged as non-IJ level or higher that have not been completed;
  3. Special Purpose Renal Dialysis Facilities (SPRDFs);
  4. Initial surveys of new providers;
  5. Past-due recertification surveys with a statutorily required survey interval; and
  6. Past-due recertification surveys without a statutorily required survey interval.

CMS also outlines how to address prior enforcement cases and an expanded desk review policy.

Laboratory guidance. Overall, CMS recommends that CLIA laboratory survey activities be reprioritized to focus on performing onsite surveys and going forward with any enforcement actions or proficiency testing (PT) desk reviews that have been on hold from either before the March 23, 2020 memo or after the memo was issued. With the exception of validation surveys on accredited laboratories and Provider Performed Microscopy Project 2020 pilot surveys, surveyors should continue to take individual laboratory location limitations and restrictions into account as they plan their re-prioritization of surveys, according to CMS.

CMS also provides details on how surveys of CLIA laboratory activities should be reprioritized, and clearly states that validation surveys on accredited laboratories and Provider Performed Microscopy Project surveys will not resume at this time.

MainStory: TopStory CMSLetters CMSNews Covid19 LaboratoryNews LTCHNews

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