The Centers for Medicare and Medicaid (CMS) has issued a new Quality & Safety Memo, QSO-23-10-NH, replacing the previous memo QSO-20-31-ALL. This revised guidance strengthens enforcement efforts for noncompliance with infection control deficiencies in nursing homes and other healthcare facilities. Enhanced enforcement actions are more stringent for infection control deficiencies that result in actual harm or immediate jeopardy to residents. The criteria for enhanced enforcement on infection control deficiencies that result in no resident harm has been expanded to include noncompliance with Infection Prevention and Control (F880) combined with COVID-19 Vaccine Immunization Requirements for Residents and Staff (F887). CMS is providing guidance to State Survey Agencies and CMS locations on handling enforcement cases before and after the revisions. Quality Improvement Organizations have been refocused to assist nursing homes in combating COVID-19 through education, training, action plans, and infection control program establishment. The strengthened Enhanced Enforcement guidance applies to enforcement cases with a survey cycle start date on or after the effective date of the memo.

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