COVID-19 Update: Survey suspension FAQs

The Centers for Medicare & Medicaid Services (CMS) previously issued guidance suspending non-emergency survey inspections in order to allow surveyors to focus on the most current and serious health and safety threats, like infectious diseases and abuse. This shift in survey prioritization was established to assist surveyors in addressing the spread of COVID-19 (coronavirus).

On March 10, 2020, CMS issued frequently asked questions (FAQs) to clarify the guidance, which include the following points of interest for health care entities:

Scope of suspension
CMS explained that only non-emergency survey activities have been suspended and that any information or complaints that raise concerns related to immediate jeopardy or allegations of abuse will be investigated. CMS clarified that surveys for existing in-process enforcement actions and surveys mandated by law to occur within specific time intervals will continue uninterrupted.

Initial surveys and other mandated surveys continue
CMS clarified that initial certification surveys for new providers to support building health care capacity will also continue. This means that revalidation surveys and non-statutory recertification surveys are suspended. CMS anticipates this suspension to be time-limited but gave no end date.

Focus on COVID-19 issues
In response to the question “What should healthcare facilities expect during the survey suspension period?” CMS states that health care facilities should focus efforts on infection disease protocols, including preparing for treating patients with COVID-19. For surveys resulting from situations specific to COVID-19, CMS will coordinate with the Centers for Disease Control and Prevention (CDC) as well as other state and local health departments on the timing and conduct of investigations.

Accrediting organization (AO) surveys and potential delays
CMS instructed AOs to ask facilities if there are or have been cases of COVID-19 prior to conducting a survey of that facility. If the facility has treated patients with COVID-19, CMS states that the AO should wait until the CDC has cleared the facility for survey. CMS noted that such delays would not have a negative impact if the facility cannot be surveyed prior to the expiration of its current accreditation period (i.e., facilities will not be de-certified).

Additional AO survey issues
CMS notes that the suspension should not impact revisit surveys. That is, AOs are expected to complete revisit surveys in order to determine the extent to which the provider has corrected any deficiencies. AOs may conduct reaccreditation surveys. However, CMS has instructed the AOs to prioritize “providers/suppliers in States affected by COVID-19 and those that have a history of infection control deficiencies.”

Clinical Laboratory Improvement Amendments (CLIA) surveys not impacted
CMS provides that the suspension does not apply to CLIA surveys at this time. Laboratory surveys should be expected to continue as normal.