As COVID-19 hits Iowa nursing homes, feds suspend fines and penalties

With COVID-19 now confirmed at several Iowa nursing homes, the federal Centers for Medicare and Medicaid Services has suspended selected fines and other penalties against long-term care facilities.

Iowa Health Care Association President and CEO Brent Willett said Wednesday the organization is “aware that four long-term care providers have reported a combined total of five positive cases of COVID-19. These providers are in Dubuque, Linn, Poweshiek and Washington counties, and all but one of the positive cases involved employees. Those impacted are receiving medical care and will remain in isolation for at least 14 days.”

Willett said the association, which represents 790 long-term care facilities in the state, asks that members of the public refrain from visiting nursing homes and assisted living centers. “All Iowa nursing facilities are following guidance from the Centers for Medicare and Medicaid Services and are not allowing visitors except for medical necessity and end-of-life situations,” he said. “Those visitors must pass screening protocols. Employees are also screened before they begin their shift.”

According to new, written guidelines from CMS, any federal fines already being imposed on a per-day basis to bring facilities into compliance with regulations are now suspended. Orders restricting the flow of Medicaid money to facilities due to quality-of-care issues are also being suspended.

The federal agency, which delegates nursing home inspections to state agencies such as Iowa’s Department of Inspections and Appeals, has also suspended routine, annual inspections and revisits except in cases where residents of a home are deemed to be in immediate jeopardy, which is a finding that usually stems from an inspection.

The new guidelines will remain in place for at least the next two weeks, during which time, targeted infection-control inspections of certain care facilities will be conducted. The homes selected for those inspections will be identified through collaboration with the Centers for Disease Control and Prevention and the Department of Health and Human Services’ assistant secretary for preparedness and response. Inspections will also be carried out to license any new facilities that are now prepared to open for business.

No inspections are to be conducted on-site if the state inspectors lack access to personal protective equipment, CMS officials said.

It was a Washington state nursing home, the Life Care Center in Kirkland, where 81 residents became infected with COVID-19 and 26 died. Kirkland has been called “ground zero” by CMS Administrator Seema Verma, noting that was the first location in the country with a high concentration of cases.