Failure by three nursing homes to provide an adequate level of care to residents during the COVID-19 crisis has resulted in the Massachusetts’ Medicaid program issuing termination notices. These notifications are the first step in the process of being removed from MassHealth, the agency that oversees the state’s Medicaid program and has the power to close the facilities.
The parent company for two of the three nursing homes claims that the State Department of Public Health (DOH) found both facilities to be in compliance with infection control standards in three of four recent visits. The company plans to appeal the allegations for those two facilities. One of the two facilities reported 12 deaths from COVID-19, and the other had no reported deaths.
The third nursing home has not been responsive to inquiries about the termination notice. There have been 10 deaths in that facility.
DOH alleges that the three facilities were not in compliance in these areas: basic infection control practices, proper use of personal protective equipment (PPE), and adequate staffing. Also, in certain cases, DOH alleges that the facilities refused the support offered by the state for dealing with outbreaks.
Compliance Perspective
Failure to implement and follow the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) guidelines for preventing and controlling the spread of COVID-19 may result in being terminated as a Medicaid provider and deemed to be providing substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures to ensure that CMS and CDC guidelines are in place and being followed for infection control, PPE, and staffing.
- Train staff on infection control protocols and proper use of PPE.
- Periodically audit to determine if the facility’s infection control program is being followed, if staff are trained in the proper use of PPE, and that staffing levels are adequate to carry-out CMS and CDC cohorting guidelines for staff and residents.
