The COVID-19 pandemic has brought renewed attention to a proposed rules change by the Centers for Medicare and Medicaid Services that would, among other changes, ease infection control requirements for nursing homes, USA Today reported.
What's the proposal? Last year, before the coronavirus pandemic, CMS proposed a rule change that would give nursing homes more authority to decide how much time an infection control preventionist has to devote to their facility. The current requirement is "at least part time," but the change would modify that to "sufficient time," which is an undefined term that gives more flexibility for facilities to decide.
The rule would also change the requirement for frequency of facilitywide assessments from every year to every other year.
What's the argument in favor of this change? Some medical officials believe the current federal government regulations are too burdensome, and not effective in improving infection control at nursing homes. The change also wouldn't require less infection control, but it would allow facilities to have more if they felt it was needed.
"This is a person-centered approach to care and would allow CMS to hold facilities accountable by having the infection preventionist onsite full time, especially in times of an outbreak," a CMS statement said last week, USA Today reported.
Gregory Johnson, the chief medical officer for the Good Samaritan Society, said strict regulations can prevent facilities from allocating resources where they're most needed, and the annual assessment, of which infection control is a small part, is a time-intensive process.
"Sometimes regulation hinders us from putting resources where we know they need to be," Johnson told USA Today.
What's the argument against the change? The COVID-19 pandemic has severely hurt nursing homes. Roughly 25% of all the coronavirus deaths in the United States have been nursing home deaths. Infections have always been a big problem for nursing homes, and COVID-19 has highlighted that issue in an unprecedented way.
According to CMS, between 1.6 million and 3.8 million infections occur in the nation's 15,600 nursing homes, with about 388,000 deaths attributed to infections.
Who will make the decision? CMS said the proposal is still under review. The agency has the authority to change the regulations for nursing homes without legislation.