The Centers for Medicare & Medicaid Services would expand and extend COVID-era respiratory illness reporting requirements under a provision of the recently proposed Home Health Prospective Payment System rule for 2025.
In May 2020, CMS began requiring nursing homes to report data on COVID-19 to the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN). Those reporting requirements were set to expire at the end of this year, but the newly proposed rule would extend them indefinitely and further expand them to include reporting on the flu and RSV.
The NHSN is a key infection tracking system for the federal government, but long-term care providers have often struggled to meet its heightened reporting demands since they began. Some nursing sector leaders have argued that the requirements are both too frequent and potentially redundant — requiring extra work for staff and increased potential for fines for providers.
The NHSN requirements should have been allowed to expire “so there would be one less burden for facility leaders and their time can be spent focusing on resident needs rather than reporting requirements,” said Denise Winzeler, RN, curriculum development specialist at the American Association of Post-Acute Care Nursing.
Winzeler told McKnight’s Long-Term Care News Monday that NHSN vaccination rate reporting will become redundant before the end of this year.
“The vaccination reporting requirements for residents will be reported through the MDS beginning October 1, 2024 which should eliminate the need for duplicate reporting of this data on NHSN.”
On Friday — two days after the extension was proposed — nonprofit nursing home group LeadingAge weighed in with a report on the rule, noting that it ignored the group’s recent advocacy efforts with CMS.
“This action is in direct contradiction of LeadingAge’s May 31 advocacy to significantly modify NHSN reporting,” wrote Jodi Eyigor, LeadingAge’s director of nursing home quality public policy. “LeadingAge notes that the proposed requirements come only months after hospitals ceased COVID data reporting through NHSN and will duplicate existing requirements for both reporting of communicable diseases and reporting of resident immunization status.”
Under the proposal, nursing homes would have to report data on cases, vaccination rates and hospitalizations for the major respiratory diseases. They could also be asked to provide additional information in the case of a new public health emergency “without notice and comment rulemaking,” Eyigor noted.
In the proposal, CMS asked providers to use the 60-day comment period to suggest ways to “minimize” the reporting burden of the NHSN requirements.
This request could be taken as a positive gesture, but Eyigor noted that LeadingAge had already asked CMS to end or significantly reduce the frequency of NHSN requirements in the letter at the end of May.
“CMS is no longer using this data for mitigation strategies, such as providing COVID tests or PPE,” Winzeler told McKnight’s. “We [AAPACN] do not see the benefit to extending these requirements and hope that CMS will take comments to this proposed extension into consideration and let these reporting requirements lapse or at least lessen the number of times this data needs to be reported to NHSN.”
The American Health Care Association also expressed concerns about redundant data reporting work for nursing home staff Monday.
“We support transparency and reasonable data collection,” said Holly Harmon, senior vice president of quality and regulatory & clinical services at AHCA. “However, extensive and duplicative reporting requirements take precious time and resources away from resident care. It is crucial that CMS balance these requirements to only what is necessary so staff can keep focus on delivering care to their residents.”
