Six of Eight Home Health Agency Providers Had Infection Control Policies and Procedures That Complied With CMS Requirements and Followed CMS COVID-19 Guidance To Safeguard Medicare Beneficiaries, Caregivers, and Staff During the COVID-19 Pandemic

Why OIG Did This Audit

Medicare beneficiaries receiving home health services may be at a high risk of developing severe illness from COVID-19. Home health agencies (HHAs) must comply with the Centers for Medicare & Medicaid Services' (CMS's) infection prevention and control requirements and follow CMS guidance by having policies and procedures to protect HHA staff, Medicare beneficiaries, and caregivers during the pandemic.

Our objective was to determine whether eight selected HHAs had infection control policies and procedures that complied with CMS requirements and followed CMS guidance to safeguard HHA staff, Medicare beneficiaries, and caregivers during the COVID-19 pandemic.

How OIG Did This Audit

Our audit covered the infection prevention and control policies and procedures for eight HHA providers. We reviewed each HHA provider's policies and procedures to determine whether they include: (1) guidance for following standards of practice, (2) a coordinated agencywide infection control program, and (3) infection control education for HHA staff, Medicare beneficiaries, and caregivers. We also determined whether the HHA providers' policies and procedures followed CMS COVID-19 guidance for: (1) screening patients, (2) screening staff, and (3) treating patients with known or suspected COVID-19.

What OIG Found

Six of the eight selected HHA providers had infection control policies and procedures that complied with CMS requirements and followed CMS guidance to safeguard HHA staff, Medicare beneficiaries, and caregivers during the COVID-19 pandemic. However, one HHA provider did not comply with CMS requirements or follow CMS COVID-19 guidance. Specifically, this HHA provider's infection control policies and procedures did not: (1) require staff to follow one of the standard precautions to prevent the transmission of infections and communicable diseases, (2) include documentation of surveillance methods used for identifying and tracking infections and improvement activities to prevent infection, (3) include COVID-19 screening protocols for staff in accordance with CMS guidance, and (4) include information about how to care for patients with known or suspected COVID-19 in accordance with CMS guidance. In addition, this provider and another HHA provider's COVID-19 screening protocols for patients were not consistent with CMS guidance. As a result, the patients and staff at these two HHA providers were at an increased risk of infection. We did not determine whether these HHA providers had infection prevention and control issues related to the implementation of the policies and procedures. However, State survey agencies identified issues with implementation at several of these HHA providers, as indicated by infection prevention and control deficiencies found during surveys conducted in 2019 and 2020.

What OIG Recommends

We recommend that CMS develop and share with the HHA industry information on COVID-19 infection prevention and control best practices that HHA providers can use to comply with CMS requirements and follow CMS guidance.

CMS concurred with our recommendation. CMS stated that it has provided education and outreach to HHAs on CMS quality and safety standards to support their infection prevention and control efforts. CMS also stated that it will continue to share information on best practices with the HHA industry.