CMS issued an interim final rule, effective May 1, which establishes explicit reporting requirements for long term care facilities to report information related to COVID-19 cases among facility residents and staff to the National Healthcare Safety Network (NHSN) COVID-19 module.

As a reminder, the new rule requires reporting starting last Friday, May 1, which must be done at least weekly. This makes Friday, May 8 the end of the first reporting period.

The CDC recommends daily reporting to NHSN. This will provide the timeliest data which will be informative and provide situational awareness at both state and national levels. The CDC recognizes that this may not be possible and requests that at a minimum the center should enter data at least once a week and at the same time. 

What to Do While Waiting for NHSN Registration

Currently enrolled facilities will see the new module when they log in. Centers who were not previously enrolled in NHSN will be required to go through an expedited enrollment process. AHCA continues to advocate for CMS to allow a grace period from enforcement due to the length of time necessary for nursing homes to gain access to NHSN as well as time needed to establish systems for reporting.

Providers are running into delays while trying to complete the NHSN registration process. The CDC has reported a backlog of providers needing assistance with registering for NHSN. In some instances, the CDC reports that it may take five to seven days to receive a response due to the sheer numbers of facilities trying to register for NHSN.

While waiting for the registration process to complete, you should download the four data collection pathway forms and accompanying instructions to start collecting the data that you will be uploading to NHSN once registration process is complete. It is extremely important to download, and refer to, the instructions page for each of the four data collection pathways. Refer to the definitions of each term prior to completing the data collection form.

The four data collection pathway forms are:

• Resident Impact and Facility Capacity 
• Staff and Personnel Impact 
• Supplies and Personal Protective Equipment 
• Ventilator Capacity and Supplies 

Public Posting of NHSN Data Anticipated by End of May

CMS anticipates publicly posting CDC’s NHSN data (including facility names, number of COVID-19 suspected and confirmed cases, deaths, and other data as determined appropriate) weekly on Monday’s at https://data.cms.gov/ by the end of May. 

NHSN COVID-19 Retrospective Reporting to January 1 Optional

There has been some confusion as to whether retrospective reporting in NHSN COVID-19 module is required or not. AHCA has confirmed with CDC that it is optional to submit data back to January 1, 2020. CDC also stated that retrospective reporting was optional at the end of its pre-recorded NHSN training webinar on May 5. CDC is working on revisions to the NHSN guide and instructions to make this clearer. We are also expecting CMS to issue a memo this week that will answer several questions that have been raised about this requirement as well as the new resident, representative, family notification requirement.

Q&A Sessions

CDC is offering several live Q&A sessions for nursing homes between May 6-14. Details can be found on the CDC NHSN website. Scroll down to the training section.

Reporting Cases in Assisted Living

Use of the NHSN is only required for nursing facilities, however, assisted living communities may report through NHSN if they so choose; the reporting module offers such a mechanism for AL communities. As a reminder, in Virginia ALFs must notify the local health department and the VDSS licensing inspector when a resident, staff, or healthcare worker has visited the facility and tests positive for COVID-19. Facilities may also consult AHCA/NCAL’s guidance on notifications.