The Infection Preventionist’s Guide to Understanding CMS Long-term Care Compliance

Session Description: The Centers for Medicare and Medicaid Services (CMS) is legally mandated with improving the quality of care, including infection prevention practices, for nursing home residents. The regulatory requirements, also known as the “Conditions of Participation (CoPs)” and the accompanying survey process are to ensure compliance is enforced, the resident is receiving safe, quality care, and facilities can continue to received federal funding.

The COVID-19 pandemic revealed that many of the long-term care facilities (LTCF), caring for the most vulnerable populations lacked the resources and training in infection prevention to effectively manage COVID, additional infections, and the ongoing transmission of multi-drug resistant organisms (MDROs).

The CoPs contain numerous standards with maintaining an effective infection prevention program by preventing pathogen occurrence and transmission. Facilities must demonstrate improved clinical outcomes, safety, and data transparency with process/outcome data. Failure to be compliant can lead to civil money penalties (CMP), sanctions, and termination.

Financial incentives/disincentives, with infection preventionist implications, through the “Skilled Nursing Facility Value-Based Purchasing Program” has begun to connect governmental reimbursement to optimal outcomes, best practices, and satisfaction.

This interactive session will proactively assist the infection preventionist with an understanding of the CMS regulations and survey process requirements. The “State Operations Manual“, “Interpretive Guidelines”, “Critical Element Pathways”, and other key documents will be reviewed. Best practice and successful strategies for continuous survey preparedness will be emphasized. Infection prevention, quality assurance and performance improvement initiatives will be discussed.