CMS doesn’t know if hospitals are ready for the next pandemic

CMS cannot ensure that hospitals are prepared for emerging threats of infectious diseases as well COVID-19, according to a federal guard report released Monday.

Although the agency announced in February 2019 that hospitals would plan potential outbreaks, CMS cannot confirm that all hospitals have updated their emergency preparedness plans during the pandemic because it inspects them only every three to five years, the HHS inspector general’s office said in its report. This is mainly because CMS may not need accreditation organizations, which inspect about 90% of Medicare and Medicaid-approved hospitals, to conduct more frequent or targeted quality and safety surveys. infection control inspections.

“The limited authority of CMS creates a significant risk that it will not be able to ensure quality and safety in the nearly 4,200 accredited hospitals across the United States the next time an emerging infectious disease threatens the country,” he said. report.

The agency will have to wait until February 1 to get this information.

In response to a wave of reports that hospitals had inadequate infection control practices, CMS directed state survey agencies, which certify about 10% of hospitals approved by Medicare and Medicaid, to conduct and prioritize targeted infection control tests starting in March 2020. State survey agencies have stopped giving priority to inspections in August, but are still doing them as needed.

“Targeted infection control investigations should use an investigation tool provided by CMS to ensure that providers have implemented actions to protect the health and safety of individuals in response to COVID-19,” he said. said the report.

CMS had asked accreditation organizations to conduct similar inspections, but they refused to do so, citing security concerns.

“The organizations also said that during this period when they believed it was unsafe to conduct targeted infection control surveys, they conducted triennial re-accreditation surveys using remote access technology and highlighted the control. of infections, ”the report said.

But according to HHS OIG, accreditation organizations have conducted only 148 triennial inspections and no complaint investigations involving infection control or emergency preparedness from March to August last year, leaving the remaining accredited hospitals largely unattended. . State survey agencies served as backstop, conducting infection control surveys at about 13% of accredited hospitals during that period. However, they could not inspect the hospitals in 13 states because they did not have the authority to do so.

The federal watchdog has recommended that CMSs require accreditation organizations to conduct special surveys after publishing new participation or guidance requirements and during a public health emergency to address the risks posed by the crisis.

CMS agreed with the OIG recommendation.

Hospitals can participate in Medicare and Medicaid if they get approval from a state survey agency or from one of four accrediting organization. State survey agencies certify hospitals every five years, while accreditation organizations survey hospitals every three years.