The Pennsylvania Department of Health (PA-DOH) recently announced that since February, surveyors conducted 1,473 inspections of Pennsylvania’s almost 700 nursing homes, including 907 complaint investigations during the COVID-19 pandemic. These resulted in 10 sanctions finalized against nursing homes, and the issuance of two provisional one licenses and over $93,000 in civil money penalties.
Officials explained that sanctions can result in civil money penalties, prohibitions related to admissions, and revoking of a facility’s license or being provisionally licensed—all of which can increase the number of required inspections. Provisional licenses can be renewed no more than three times. Once all issues have been corrected satisfactorily, DOH can return the facility to a regular license.
While the state’s health secretary noted that nursing homes have been particularly challenged during the COVID-19 pandemic, she also said, “That is why we remain committed to protecting the health and well-being of our most vulnerable Pennsylvanians by continuing to hold nursing home operators accountable, as necessary, to ensure they are providing safe care. If you see something at a nursing home that doesn’t seem right, we encourage you to speak up.”
Onsite inspections are focused on COVID-19 infection control compliance. Although annual on-site inspections are not occurring in Pennsylvania at this time, extensions are in place based on guidance from the Centers for Medicare & Medicaid Services (CMS). The majority of inspections are being conducted virtually to prevent the spread of COVID-19.
The PA-DOH conducted 5,381 inspections of nursing homes in 2019 that included 3,285 complaint investigations. Finalized sanctions against nursing homes totaled 213, with issuance of civil money penalties of over $2.5 million dollars.
Compliance Perspective
Failure of a facility to comply with COVID-19 infection control requirements or to fully investigate and correct conditions that lead to complaints to the DOH may result in DOH-issued sanctions, including assessment of a civil money penalty, restrictions on admissions, having the facility’s license revoked, or provisional licensure with additional inspections.
Discussion Points:
- Review policies and procedures regarding the facility’s Compliance and Ethics Program to ensure that all incidents and complaints are being fully investigated, with areas of concern corrected. Also review Infection Control Plan details and ensure CMS and CDC requirements are implemented and sustained.
- Train staff regarding abuse, neglect, and exploitation and the protocols they need to follow to report any observed incident, complaint, or reasonable suspicion of non-compliance to their supervisor or through the facility’s Hotline. Provide additional training on infection control practices as updates occur or as additional training needs become evident.
- Periodically audit to ensure that a proper investigation is completed for all reported concerns and that corrective measures are implemented for any reportable incident or complaint. Conduct the CMS COVID-19 Facility Preparedness Self-Assessment to identify any areas of non-compliance with CMS and CDC guidelines.
